Provider Demographics
NPI:1346545704
Name:WATERS, STEPHEN EDWARD (DC, LICAC, DNM)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:EDWARD
Last Name:WATERS
Suffix:
Gender:M
Credentials:DC, LICAC, DNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4200 SE SADDLEBROOK CIR
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64082-4944
Mailing Address - Country:US
Mailing Address - Phone:816-898-4414
Mailing Address - Fax:816-817-0200
Practice Address - Street 1:4200 SE SADDLEBROOK CIR
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64082-4944
Practice Address - Country:US
Practice Address - Phone:816-898-4414
Practice Address - Fax:816-817-0200
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-17
Last Update Date:2013-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath