Provider Demographics
NPI:1093879678
Name:STEPHENS, WAYNE A II (DC)
Entity Type:Individual
Prefix:DR
First Name:WAYNE
Middle Name:A
Last Name:STEPHENS
Suffix:II
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 1:2417 JORDAN LN NW
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35816-1009
Mailing Address - Country:US
Mailing Address - Phone:256-721-9617
Mailing Address - Fax:256-837-1206
Practice Address - Street 1:2417 JORDAN LN NW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35816-1009
Practice Address - Country:US
Practice Address - Phone:256-721-9617
Practice Address - Fax:256-837-1206
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2008-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2195111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor