Provider Demographics
NPI:1003276981
Name:STEFAN, BRETT CHRISTOPHER (DC, MS)
Entity Type:Individual
Prefix:DR
First Name:BRETT
Middle Name:CHRISTOPHER
Last Name:STEFAN
Suffix:
Gender:M
Credentials:DC, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2879 E DUBLIN GRANVILLE RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43231-4063
Mailing Address - Country:US
Mailing Address - Phone:614-392-2732
Mailing Address - Fax:614-392-2792
Practice Address - Street 1:2879 E DUBLIN GRANVILLE RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43231-4063
Practice Address - Country:US
Practice Address - Phone:614-392-2732
Practice Address - Fax:614-392-2792
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-04
Last Update Date:2016-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4558111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH4558OtherCHIROPRACTIC LICENSE