Provider Demographics
NPI:1871773663
Name:SPRAGUE, STEVEN ANDREW (DC)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:ANDREW
Last Name:SPRAGUE
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 1:790 LAUREL ST
Mailing Address - Street 2:STE 15
Mailing Address - City:SAN CARLOS
Mailing Address - State:CA
Mailing Address - Zip Code:94070-3165
Mailing Address - Country:US
Mailing Address - Phone:415-378-8343
Mailing Address - Fax:
Practice Address - Street 1:790 LAUREL ST
Practice Address - Street 2:STE 15
Practice Address - City:SAN CARLOS
Practice Address - State:CA
Practice Address - Zip Code:94070-3165
Practice Address - Country:US
Practice Address - Phone:415-378-8343
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-08
Last Update Date:2017-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC-30648111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor