Provider Demographics
NPI:1851864466
Name:STEVENSON CHIROPRACTIC
Entity Type:Organization
Organization Name:STEVENSON CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:DEANNA
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:STEVENSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC, ATC/L
Authorized Official - Phone:479-841-9947
Mailing Address - Street 1:9249 S BROADWAY UNIT 100
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80129-5691
Mailing Address - Country:US
Mailing Address - Phone:303-470-1020
Mailing Address - Fax:
Practice Address - Street 1:9249 S BROADWAY UNIT 100
Practice Address - Street 2:
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80129-5691
Practice Address - Country:US
Practice Address - Phone:303-470-1020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-07
Last Update Date:2019-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty