Provider Demographics
NPI:1295938512
Name:DIERENFIELD, STEVEN LEE (DC)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:LEE
Last Name:DIERENFIELD
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 1:1532 E MULBERRY ST
Mailing Address - Street 2:SUITE E
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80524-3552
Mailing Address - Country:US
Mailing Address - Phone:970-493-4600
Mailing Address - Fax:970-493-4466
Practice Address - Street 1:1532 E MULBERRY ST
Practice Address - Street 2:SUITE E
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524-3552
Practice Address - Country:US
Practice Address - Phone:970-493-4600
Practice Address - Fax:970-493-4466
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2109111N00000X
WY1034111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO46053Medicare ID - Type Unspecified