Provider Demographics
NPI:1558474668
Name:STEELY, KRISTEN M (DC)
Entity type:Individual
Prefix:DR
First Name:KRISTEN
Middle Name:M
Last Name:STEELY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:KRISTEN
Other - Middle Name:M
Other - Last Name:GELES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:131 BUFORD AVE
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29621-3313
Mailing Address - Country:US
Mailing Address - Phone:864-226-7676
Mailing Address - Fax:864-226-7770
Practice Address - Street 1:131 BUFORD AVE
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-3313
Practice Address - Country:US
Practice Address - Phone:864-226-7676
Practice Address - Fax:864-226-7771
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2017-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2663111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCCH2663Medicaid
SCU87671Medicare UPIN
SCCH2663Medicaid