Provider Demographics
NPI:1235408899
Name:MAKELA, STEPHANIE KAY (DC)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:KAY
Last Name:MAKELA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:KAY
Other - Last Name:ZINDA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:375 COLLINS RD NE
Mailing Address - Street 2:SUITE 22
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52402-3168
Mailing Address - Country:US
Mailing Address - Phone:319-395-9897
Mailing Address - Fax:319-395-9891
Practice Address - Street 1:375 COLLINS RD NE
Practice Address - Street 2:SUITE 22
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402-3168
Practice Address - Country:US
Practice Address - Phone:319-395-9897
Practice Address - Fax:319-395-9891
Is Sole Proprietor?:No
Enumeration Date:2011-12-27
Last Update Date:2015-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4821-12111N00000X
IA076964111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor