Provider Demographics
NPI:1720273469
Name:STEMEN CHIROPRACTIC CLINIC INC
Entity Type:Organization
Organization Name:STEMEN CHIROPRACTIC CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:T
Authorized Official - Last Name:STEMEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:419-227-8700
Mailing Address - Street 1:1601 ALLENTOWN RD
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45805-1801
Mailing Address - Country:US
Mailing Address - Phone:419-227-8700
Mailing Address - Fax:419-227-9400
Practice Address - Street 1:1601 ALLENTOWN RD
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45805-1801
Practice Address - Country:US
Practice Address - Phone:419-227-8700
Practice Address - Fax:419-227-9400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-06
Last Update Date:2013-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH4029031Medicare PIN