Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | CHR.0007556 | CO |
NPI | 1386237360 |
---|---|
Provider Name | Dr. Kenneth Spencer Steffen |
First Address | Timnath, CO 80547-0272 |
Second Address | Timnath, CO 80547-8054 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/02/2021 |
Last Update Date | 19/02/2021 |