Provider Demographics
NPI:1356040786
Name:STEVENS, CHRISTOPHER (LAC)
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:
Last Name:STEVENS
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:141 WEXFORD BAYNE RD
Mailing Address - Street 2:
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-8748
Mailing Address - Country:US
Mailing Address - Phone:724-940-3900
Mailing Address - Fax:888-299-2936
Practice Address - Street 1:141 WEXFORD BAYNE RD
Practice Address - Street 2:
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-8748
Practice Address - Country:US
Practice Address - Phone:724-940-3900
Practice Address - Fax:888-299-2936
Is Sole Proprietor?:No
Enumeration Date:2023-02-24
Last Update Date:2023-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAK001380171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist