MEDICARE: DR. TERESA M STEVENS D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	3174	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	085MV	OTHER		BCBS

General Provider Information

NPI Number	:	1134124670
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TERESA M STEVENS D.C.

Provider Business Mailing Address
First Line	:	PO BOX 1235
Second Line	:
City	:	TAYLORSVILLE
State	:	NC
Zip	:	28681-1235
Country	:	US
Telephone Number	:	828-635-7377
Fax Number	:	828-635-7569

Provider Business Practice Location Address
First Line	:	12 W MAIN AVE
Second Line	:
City	:	TAYLORSVILLE
State	:	NC
Zip	:	28681-2753
Country	:	US
Telephone Number	:	828-635-7377
Fax Number	:	828-635-7569

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/20/2005
Last Update Date	:	07/08/2007

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