Provider Demographics
NPI:1689723025
Name:RALSTON, STEPHEN THOMAS (DC)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:THOMAS
Last Name:RALSTON
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 1:2514 E ALLEGHENY AVENUE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19134-5102
Mailing Address - Country:US
Mailing Address - Phone:215-425-1110
Mailing Address - Fax:215-425-5610
Practice Address - Street 1:2514 E ALLEGHENY AVENUE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19134-5102
Practice Address - Country:US
Practice Address - Phone:215-425-1110
Practice Address - Fax:215-425-5610
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC008756111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor