Provider Demographics
NPI:1972599165
Name:ACUNA, STEPHANIE MARIE (DC)
Entity Type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:MARIE
Last Name:ACUNA
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 1:7650 S MCCLINTOCK DR
Mailing Address - Street 2:PMB 364 STE 103
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85284-1672
Mailing Address - Country:US
Mailing Address - Phone:480-963-0730
Mailing Address - Fax:480-726-6798
Practice Address - Street 1:312 N ALMA SCHOOL RD
Practice Address - Street 2:STE 19
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-4354
Practice Address - Country:US
Practice Address - Phone:480-963-0730
Practice Address - Fax:480-726-6798
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7220111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U92280Medicare UPIN
71622Medicare ID - Type Unspecified