Provider Demographics
NPI:1134798143
Name:MOTZE, STEPHEN TYLER (DC)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:TYLER
Last Name:MOTZE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 S 7TH ST APT 245
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18101-2900
Mailing Address - Country:US
Mailing Address - Phone:610-468-8273
Mailing Address - Fax:
Practice Address - Street 1:6465 VILLAGE LN STE 11
Practice Address - Street 2:
Practice Address - City:MACUNGIE
Practice Address - State:PA
Practice Address - Zip Code:18062-8474
Practice Address - Country:US
Practice Address - Phone:610-421-6483
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-23
Last Update Date:2021-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC011660111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor