Provider Demographics
NPI:1275148918
Name:CHANG, STEVEN (DC)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:CHANG
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 1:1335 COPPERSHIRE CV N APT 301
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38138-2044
Mailing Address - Country:US
Mailing Address - Phone:901-484-5460
Mailing Address - Fax:
Practice Address - Street 1:1740 N GERMANTOWN PKWY STE 6
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38016-3308
Practice Address - Country:US
Practice Address - Phone:901-752-4300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-10
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR010243111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor