Provider Demographics
NPI:1891103750
Name:STEVENSON, DEANNA (DC, ATC/L)
Entity Type:Individual
Prefix:
First Name:DEANNA
Middle Name:
Last Name:STEVENSON
Suffix:
Gender:F
Credentials:DC, ATC/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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
Practice Address - Country:US
Practice Address - Phone:303-470-1020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-23
Last Update Date:2019-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAT.00019192255A2300X
COCHR.0007959111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer