Provider Demographics
NPI:1215243068
Name:STECKEL, JACOB RYAN (DC)
Entity type:Individual
Prefix:DR
First Name:JACOB
Middle Name:RYAN
Last Name:STECKEL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 36853
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89133-6853
Mailing Address - Country:US
Mailing Address - Phone:702-644-3333
Mailing Address - Fax:702-644-3336
Practice Address - Street 1:8678 SPRING MOUNTAIN RD
Practice Address - Street 2:STE 130
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-4112
Practice Address - Country:US
Practice Address - Phone:702-384-0000
Practice Address - Fax:702-221-4853
Is Sole Proprietor?:No
Enumeration Date:2010-08-30
Last Update Date:2014-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB01306111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor