Provider Demographics
NPI:1528567971
Name:STEFANACCI, ERIN
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:STEFANACCI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:474 WEBBER RD
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29307-3034
Mailing Address - Country:US
Mailing Address - Phone:239-849-2999
Mailing Address - Fax:
Practice Address - Street 1:1 VILLAGE LN STE 5
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-2617
Practice Address - Country:US
Practice Address - Phone:239-849-2999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-12
Last Update Date:2018-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4884111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor