Provider Demographics
NPI:1942318878
Name:BAHNERTH, STEVANIE (DC)
Entity Type:Individual
Prefix:DR
First Name:STEVANIE
Middle Name:
Last Name:BAHNERTH
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30825 N CAVE CREEK RD STE 127
Mailing Address - Street 2:
Mailing Address - City:CAVE CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85331-2954
Mailing Address - Country:US
Mailing Address - Phone:480-563-5006
Mailing Address - Fax:480-563-5276
Practice Address - Street 1:30825 N CAVE CREEK RD STE 127
Practice Address - Street 2:
Practice Address - City:CAVE CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85331-2954
Practice Address - Country:US
Practice Address - Phone:480-563-5006
Practice Address - Fax:480-563-5276
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7482111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor