Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 38MC00298800 | NJ |
N | 111NR0400X | Rehabilitation Chiropractor | 38MC0029880 | NJ |
NPI | 1093256356 |
---|---|
Provider Name | Dr. David Lyons Stephens |
First Address | Plainfield, NJ 07060-1203 |
Second Address | Plainfield, NJ 07060-1203 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/03/2017 |
Last Update Date | 19/03/2017 |