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General NPI Number Information
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NPI Number | 1417210873
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Entity Type | Organization
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Legal Business Name | STEGE CHIROPRACTIC HEALTH CENTER, LLC
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Dates
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Enumeration Date | 06/20/2012
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Last Update Date | 09/23/2013
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Provider Practice Location Address
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Address Line | 194 CLEVELAND ST SUITE A
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City | MANISTEE
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State | MI
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Zip | 49660-1296
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Country | US
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Telephone | 231-299-1015
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Fax | 231-299-1019
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Provider Business Mailing Address
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Address Line | 194 CLEVELAND ST SUITE A
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City | MANISTEE
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State | MI
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Zip | 49660-1296
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Country | US
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Telephone | 231-299-1015
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Fax | 231-299-1019
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Authorized Official
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Title or Position | OWNER
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Name | DR. JESSICA ANNE STEGE
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Credential | D.C.
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Telephone | 231-299-1015
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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 | 2301009198
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License Number State | MI
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