Provider Demographics
NPI:1215008271
Name:COOL, STEVEN A (DC)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:A
Last Name:COOL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3401 E THOMAS RD
Mailing Address - Street 2:SUITE G
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-7469
Mailing Address - Country:US
Mailing Address - Phone:602-955-1770
Mailing Address - Fax:602-955-0511
Practice Address - Street 1:3401 E THOMAS RD
Practice Address - Street 2:SUITE G
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018-7469
Practice Address - Country:US
Practice Address - Phone:602-955-1770
Practice Address - Fax:602-955-0511
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAZ662111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZDC662Medicare UPIN