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General NPI Number Information
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NPI Number | 1124219258
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Entity Type | Organization
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Legal Business Name | STEFOS & ASSOCIATES, LLC
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Dates
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Enumeration Date | 08/05/2007
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Last Update Date | 08/10/2007
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Provider Practice Location Address
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Address Line | 122 ELM ST
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City | WORCESTER
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State | MA
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Zip | 01609-1902
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Country | US
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Telephone | 508-754-6221
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Fax | 508-755-4741
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Provider Business Mailing Address
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Address Line | 122 ELM ST
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City | WORCESTER
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State | MA
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Zip | 01609-1902
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Country | US
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Telephone | 508-754-6221
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Fax | 508-755-4741
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Authorized Official
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Title or Position | MEMBER
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Name | DR. ELIZABETH STEFOS
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Credential | DC
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Telephone | 508-754-6221
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 290
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License Number State | MA
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