Provider Demographics
NPI:1285697805
Name:LEVINE, STEVEN LOUIS (DC)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:LOUIS
Last Name:LEVINE
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 1:751 E UNION HILLS DRIVE
Mailing Address - Street 2:SUITE 7
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85024-2979
Mailing Address - Country:US
Mailing Address - Phone:602-788-6091
Mailing Address - Fax:602-485-8276
Practice Address - Street 1:751 E UNION HILLS DRIVE
Practice Address - Street 2:SUITE 7
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85024-2979
Practice Address - Country:US
Practice Address - Phone:602-788-6091
Practice Address - Fax:602-485-8276
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5431111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ0943820OtherBCBS
102416Medicare ID - Type UnspecifiedGROUP NUMBER
102417Medicare ID - Type UnspecifiedINV NUMBER
U57864Medicare UPIN