Provider Demographics
NPI:1134124670
Name:STEVENS, TERESA M (DC)
Entity Type:Individual
Prefix:DR
First Name:TERESA
Middle Name:M
Last Name:STEVENS
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:PO BOX 1235
Mailing Address - Street 2:
Mailing Address - City:TAYLORSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28681-1235
Mailing Address - Country:US
Mailing Address - Phone:828-635-7377
Mailing Address - Fax:828-635-7569
Practice Address - Street 1:12 W MAIN AVE
Practice Address - Street 2:
Practice Address - City:TAYLORSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28681-2753
Practice Address - Country:US
Practice Address - Phone:828-635-7377
Practice Address - Fax:828-635-7569
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3174111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89085MVMedicaid
085MVOtherBCBS
2333669Medicare ID - Type Unspecified
NC89085MVMedicaid