Provider Demographics
NPI:1164840104
Name:MAROON, STEPHEN T (DC)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:T
Last Name:MAROON
Suffix:
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 1:2 DALE CIR
Mailing Address - Street 2:
Mailing Address - City:METHUEN
Mailing Address - State:MA
Mailing Address - Zip Code:01844-7315
Mailing Address - Country:US
Mailing Address - Phone:978-869-6061
Mailing Address - Fax:
Practice Address - Street 1:45 STILES RD
Practice Address - Street 2:STE 104
Practice Address - City:SALEM
Practice Address - State:NH
Practice Address - Zip Code:03079-2850
Practice Address - Country:US
Practice Address - Phone:978-869-6061
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-06
Last Update Date:2016-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH938111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor