Provider Demographics
NPI:1346587722
Name:POWELL, STEPHANIE RENEE (DC)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:RENEE
Last Name:POWELL
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 1:115 W CLINTON ST
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:MI
Mailing Address - Zip Code:48843-1565
Mailing Address - Country:US
Mailing Address - Phone:517-546-5777
Mailing Address - Fax:
Practice Address - Street 1:115 W CLINTON ST
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:MI
Practice Address - Zip Code:48843-1565
Practice Address - Country:US
Practice Address - Phone:517-546-5777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-06
Last Update Date:2013-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301007602111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor