Provider Demographics
NPI:1538478078
Name:STEGMAIER, ELIZABETH AXELROD (ND)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:AXELROD
Last Name:STEGMAIER
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2204 DIXON AVE
Mailing Address - Street 2:BLACK BEAR NATUROPATHIC CLINIC
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59801-8224
Mailing Address - Country:US
Mailing Address - Phone:406-542-2147
Mailing Address - Fax:
Practice Address - Street 1:2204 DIXON AVE
Practice Address - Street 2:BLACK BEAR NATUROPATHIC CLINIC
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59801-8224
Practice Address - Country:US
Practice Address - Phone:406-542-2147
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-01
Last Update Date:2013-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT806175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath