Healthcare Provider Details

I. General information

NPI: 1003276981
Provider Name (Legal Business Name): BRETT CHRISTOPHER STEFAN D.C., MS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/04/2016
Last Update Date: 11/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2879 E DUBLIN GRANVILLE RD
COLUMBUS OH
43231-4063
US

IV. Provider business mailing address

2879 E DUBLIN GRANVILLE RD
COLUMBUS OH
43231-4063
US

V. Phone/Fax

Practice location:
  • Phone: 614-392-2732
  • Fax: 614-392-2792
Mailing address:
  • Phone: 614-392-2732
  • Fax: 614-392-2792

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number4558
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: