MEDICARE: DR. DAVID STELLA 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	111NN1001X	Nutrition Chiropractor	B753	NV

General Provider Information

NPI Number	:	1952488298
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID STELLA D.C.

Provider Business Mailing Address
First Line	:	375 N STEPHANIE ST
Second Line	:	BLDG. 12 SUITE 1213
City	:	HENDERSON
State	:	NV
Zip	:	89014-8771
Country	:	US
Telephone Number	:	702-932-1798
Fax Number	:	702-446-8382

Provider Business Practice Location Address
First Line	:	375 N STEPHANIE ST
Second Line	:	BLDG. 12 SUITE 1213
City	:	HENDERSON
State	:	NV
Zip	:	89014-8771
Country	:	US
Telephone Number	:	702-932-1798
Fax Number	:	702-446-8382

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

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	07/08/2007

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