Basic Information
| Provider Information | |||||||||
| NPI: | 1972091700 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | STECK | ||||||||
| FirstName: | KEVIN | ||||||||
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| Credential: | DC, MS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1744 E MCANDREWS RD | ||||||||
| Address2: | STE D | ||||||||
| City: | MEDFORD | ||||||||
| State: | OR | ||||||||
| PostalCode: | 975045576 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5414140362 | ||||||||
| FaxNumber: | 5412002262 | ||||||||
| Practice Location | |||||||||
| Address1: | 624 S SEGUIN AVE | ||||||||
| Address2: | |||||||||
| City: | NEW BRAUNFELS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 781307647 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8306299909 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/26/2018 | ||||||||
| LastUpdateDate: | 03/17/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/17/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 111N00000X | 13798 | TX | Y | Chiropractic Providers | Chiropractor |
No ID Information.