Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | CHIA-1655 | ID |
NPI | 1003294281 |
---|---|
Provider Name | Dr. Hans Konrad Steidl |
First Address | Sandpoint, ID 83864-8366 |
Second Address | Sandpoint, ID 83864-8268 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2015 |
Last Update Date | 03/07/2019 |