Provider Demographics
NPI:1760545016
Name:NAULT, STEPHEN J (DC)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:J
Last Name:NAULT
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 1:33 OAK AVE
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01605-2752
Mailing Address - Country:US
Mailing Address - Phone:508-438-1444
Mailing Address - Fax:508-438-1445
Practice Address - Street 1:33 OAK AVE
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605-2752
Practice Address - Country:US
Practice Address - Phone:508-438-1444
Practice Address - Fax:508-438-1445
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2014-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2578111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA436839OtherBCBS
MASTY45458Medicare ID - Type Unspecified
MA436839OtherBCBS