Healthcare Provider Details

I. General information

NPI: 1891103750
Provider Name (Legal Business Name): DEANNA STEVENSON DC, ATC/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2014
Last Update Date: 05/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9249 S BROADWAY UNIT 100
HIGHLANDS RANCH CO
80129
US

IV. Provider business mailing address

9249 S BROADWAY UNIT 100
HIGHLANDS RANCH CO
80129-5691
US

V. Phone/Fax

Practice location:
  • Phone: 303-470-1020
  • Fax:
Mailing address:
  • Phone: 303-470-1020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberAT.0001919
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCHR.0007959
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: