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General NPI Number Information
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NPI Number | 1336457993
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Entity Type | Individual
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Provider Name | STEPHAN MOJE DC DIBCN
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Gender | Male
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Dates
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Enumeration Date | 09/16/2010
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Last Update Date | 09/19/2017
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Provider Practice Location Address
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Address Line | 8624 WINTON RD STE B
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City | CINCINNATI
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State | OH
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Zip | 45231-4837
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Country | US
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Telephone | 513-931-4300
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Fax | 513-898-9149
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Provider Business Mailing Address
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Address Line | 6635 MURRAY AVE
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City | CINCINNATI
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State | OH
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Zip | 45227-4726
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Country | US
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Telephone | 218-205-6141
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 4650-012
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 5424
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License Number State | MN
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Taxonomy #3
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 2301 009712
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License Number State | MI
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Taxonomy #4
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Taxonomy Code | 111NN0400X
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Taxonomy Name | Neurology Chiropractor
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License Number | 4113
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License Number State | OH
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Taxonomy #5
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC010283
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License Number State | PA
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