Provider Demographics
NPI:1649538984
Name:STEPPING STONE CHIROPRACTIC, LLC
Entity type:Organization
Organization Name:STEPPING STONE CHIROPRACTIC, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:
Authorized Official - Last Name:MOELLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:303-220-7837
Mailing Address - Street 1:6884 S UNIVERSITY BLVD
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80122-1515
Mailing Address - Country:US
Mailing Address - Phone:303-220-7837
Mailing Address - Fax:303-771-3099
Practice Address - Street 1:6884 S UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80122-1515
Practice Address - Country:US
Practice Address - Phone:303-220-7837
Practice Address - Fax:303-771-3099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-24
Last Update Date:2012-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5784111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1801844865OtherINDIVIDUAL NPI (ERICA MOELLER, DC)