Provider Demographics
NPI:1851527642
Name:STEPHENS CHIROPRACTIC
Entity Type:Organization
Organization Name:STEPHENS CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:CARL
Authorized Official - Last Name:STEPHENS
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:334-382-6343
Mailing Address - Street 1:202 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36037-2606
Mailing Address - Country:US
Mailing Address - Phone:334-382-6343
Mailing Address - Fax:334-382-7907
Practice Address - Street 1:202 CHURCH ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:AL
Practice Address - Zip Code:36037-2606
Practice Address - Country:US
Practice Address - Phone:334-382-6343
Practice Address - Fax:334-382-7907
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-07
Last Update Date:2009-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL0816261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center