Healthcare Provider Details

I. General information

NPI: 1174238257
Provider Name (Legal Business Name): STEWART CHIROPRACTIC CLINIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2023
Last Update Date: 06/27/2024
Certification Date: 06/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2114 CENTRAL PKWY SW STE G
DECATUR AL
35601-6850
US

IV. Provider business mailing address

1605 THOMAS DR SW
DECATUR AL
35601-2750
US

V. Phone/Fax

Practice location:
  • Phone: 256-777-6762
  • Fax: 256-649-2291
Mailing address:
  • Phone: 256-566-8619
  • Fax: 256-822-2215

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. DE'ANDRA MICHELLE STEWART
Title or Position: CHIROPRACTOR/OWNER
Credential: D.C.
Phone: 256-566-8619