Provider Demographics
NPI:1942421193
Name:STEWART, LETITIA ANN (DC)
Entity Type:Individual
Prefix:MS
First Name:LETITIA
Middle Name:ANN
Last Name:STEWART
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 1:5 NORTHERN BLVD
Mailing Address - Street 2:UNIT 6
Mailing Address - City:AMHERST
Mailing Address - State:NH
Mailing Address - Zip Code:03031
Mailing Address - Country:US
Mailing Address - Phone:603-249-9855
Mailing Address - Fax:603-882-9041
Practice Address - Street 1:5 NORTHERN BLVD
Practice Address - Street 2:UNIT 6
Practice Address - City:AMHERST
Practice Address - State:NH
Practice Address - Zip Code:03031
Practice Address - Country:US
Practice Address - Phone:603-249-9855
Practice Address - Fax:603-882-9041
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2010-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH5930200111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30393499Medicaid
NH30393499Medicaid