Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | KY 4111 | KY |
NPI | 1003977687 |
---|---|
Provider Name | Dr. Stefan Eugene Cesarz |
First Address | Hardinsburg, KY 40143-2580 |
Second Address | Hardinsburg, KY 40143-2580 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/12/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
85000602 | (05) | KY |
U43280 | (02) |