Provider Demographics
NPI:1518570951
Name:STEVENSON, TONY CURTIS (DC)
Entity Type:Individual
Prefix:DR
First Name:TONY
Middle Name:CURTIS
Last Name:STEVENSON
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 1:2841 MECCA DR
Mailing Address - Street 2:
Mailing Address - City:PLOVER
Mailing Address - State:WI
Mailing Address - Zip Code:54467-3228
Mailing Address - Country:US
Mailing Address - Phone:715-498-9227
Mailing Address - Fax:
Practice Address - Street 1:2841 MECCA DR
Practice Address - Street 2:
Practice Address - City:PLOVER
Practice Address - State:WI
Practice Address - Zip Code:54467-3228
Practice Address - Country:US
Practice Address - Phone:715-498-9227
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-25
Last Update Date:2020-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5548-12111NX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0100XChiropractic ProvidersChiropractorOccupational Health