MEDICARE: DR. JOSEPH RICHARD 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	007456	IA
2	111N00000X	Chiropractor	5534	MN

General Provider Information

NPI Number	:	1336425420
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH RICHARD STEVENS D.C.

Provider Business Mailing Address
First Line	:	1010 240TH ST NE
Second Line	:	UNIT 8
City	:	NORTH LIBERTY
State	:	IA
Zip	:	52317-9132
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1010 240TH ST NE
Second Line	:	UNIT 8
City	:	NORTH LIBERTY
State	:	IA
Zip	:	52317-9132
Country	:	US
Telephone Number	:	507-923-5763
Fax Number	:

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

Provider Enumeration Date	:	11/02/2011
Last Update Date	:	11/02/2011

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