Provider Demographics
NPI:1528008224
Name:PRICE, STEPHEN D (DC)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:D
Last Name:PRICE
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 1:2250 PONTIAC TRL
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105-1280
Mailing Address - Country:US
Mailing Address - Phone:734-995-8938
Mailing Address - Fax:
Practice Address - Street 1:2250 PONTIAC TRL
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48105-1280
Practice Address - Country:US
Practice Address - Phone:734-995-8938
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301006576111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor