MEDICARE: DR. STEPHANIE J. VELDMAN DC,CCSP

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	111NS0005X	Sports Physician Chiropractor	A5663	IA

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

General Provider Information

NPI Number	:	1295727394
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHANIE J. VELDMAN DC,CCSP

Provider Business Mailing Address
First Line	:	2007 18TH ST
Second Line	:	SUITE 1
City	:	SPIRIT LAKE
State	:	IA
Zip	:	51360-1061
Country	:	US
Telephone Number	:	712-336-1330
Fax Number	:	712-336-4240

Provider Business Practice Location Address
First Line	:	2007 18TH ST
Second Line	:	SUITE 1
City	:	SPIRIT LAKE
State	:	IA
Zip	:	51360-1061
Country	:	US
Telephone Number	:	712-336-1330
Fax Number	:	712-336-4240

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

Provider Enumeration Date	:	08/16/2005
Last Update Date	:	07/09/2007

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