Provider Demographics
NPI:1033446141
Name:ESTES, STEPHANIE ANGELLETTE (DC)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:ANGELLETTE
Last Name:ESTES
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:702 GROVE ST, STE 102
Mailing Address - Street 2:
Mailing Address - City:LOUDON
Mailing Address - State:TN
Mailing Address - Zip Code:37774-1481
Mailing Address - Country:US
Mailing Address - Phone:865-657-9941
Mailing Address - Fax:865-657-9942
Practice Address - Street 1:702 GROVE ST, STE 102
Practice Address - Street 2:
Practice Address - City:LOUDON
Practice Address - State:TN
Practice Address - Zip Code:37774-1481
Practice Address - Country:US
Practice Address - Phone:865-657-9941
Practice Address - Fax:865-657-9942
Is Sole Proprietor?:No
Enumeration Date:2009-11-10
Last Update Date:2010-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2383111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor