Provider Demographics
NPI:1659426849
Name:STEDMAN CHIROPRACTIC CENTRE, P.C.
Entity Type:Organization
Organization Name:STEDMAN CHIROPRACTIC CENTRE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:STEDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:989-681-2533
Mailing Address - Street 1:1883 W MONROE RD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MI
Mailing Address - Zip Code:48880-9789
Mailing Address - Country:US
Mailing Address - Phone:989-681-2533
Mailing Address - Fax:989-681-2533
Practice Address - Street 1:1883 W MONROE RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MI
Practice Address - Zip Code:48880-9789
Practice Address - Country:US
Practice Address - Phone:989-681-2533
Practice Address - Fax:989-681-2533
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIES005733111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0B91040OtherBLUE CROSS BLUE SHIELD
MI1008320OtherMCLAREN HEALTH PLAN
MI2849354Medicaid
MI2849354Medicaid
MIU36450Medicare UPIN