Provider Demographics
NPI:1851735534
Name:WUNNENBERG, STEVEN KYLE (DC)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:KYLE
Last Name:WUNNENBERG
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 1:925 BENTON RD
Mailing Address - Street 2:
Mailing Address - City:BOSSIER CITY
Mailing Address - State:LA
Mailing Address - Zip Code:71111-3603
Mailing Address - Country:US
Mailing Address - Phone:318-747-4433
Mailing Address - Fax:318-747-4454
Practice Address - Street 1:925 BENTON RD
Practice Address - Street 2:
Practice Address - City:BOSSIER CITY
Practice Address - State:LA
Practice Address - Zip Code:71111-3603
Practice Address - Country:US
Practice Address - Phone:318-747-4433
Practice Address - Fax:318-747-4454
Is Sole Proprietor?:No
Enumeration Date:2013-04-24
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1866111N00000X
TX12231111NR0400X, 111NS0005X, 111NX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
Yes111N00000XChiropractic ProvidersChiropractor
No111NS0005XChiropractic ProvidersChiropractorSports Physician
No111NX0100XChiropractic ProvidersChiropractorOccupational Health