Provider Demographics
NPI:1427358266
Name:STECZEK, ELISABETH ANN (DC)
Entity Type:Individual
Prefix:DR
First Name:ELISABETH
Middle Name:ANN
Last Name:STECZEK
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:ELISABETH
Other - Middle Name:ANN
Other - Last Name:LIND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:30061 SCHOENHERR RD STE B
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48088-3133
Mailing Address - Country:US
Mailing Address - Phone:586-576-0701
Mailing Address - Fax:
Practice Address - Street 1:30061 SCHOENHERR RD STE B
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48088-3133
Practice Address - Country:US
Practice Address - Phone:586-576-0701
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-27
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301009728111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
950F39338OtherBCBS
MI0N24700Medicare PIN