Provider Demographics
NPI:1124219258
Name:STEFOS & ASSOCIATES, LLC
Entity Type:Organization
Organization Name:STEFOS & ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:STEFOS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:508-754-6221
Mailing Address - Street 1:122 ELM ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01609-1902
Mailing Address - Country:US
Mailing Address - Phone:508-754-6221
Mailing Address - Fax:508-755-4741
Practice Address - Street 1:122 ELM ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01609-1902
Practice Address - Country:US
Practice Address - Phone:508-754-6221
Practice Address - Fax:508-755-4741
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-05
Last Update Date:2007-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA290111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty