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NPI 1720150469

NPI 1720150469 : SHAWN STENSTROM D.C. : GLENDALE, AZ

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General NPI Number Information
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    NPI Number           |    1720150469
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    Entity Type          |    Individual 
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    Provider Name        |    SHAWN STENSTROM D.C.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    11/15/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    5730 W PEORIA AVE 
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    City                 |    GLENDALE
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    State                |    AZ
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    Zip                  |    85302-1423
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    Country              |    US
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    Telephone            |    623-878-5991
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    5953 E JUNIPER AVE 
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    City                 |    SCOTTSDALE
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    State                |    AZ
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    Zip                  |    85254-9226
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    Country              |    US
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    Telephone            |    
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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       |    7367
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    License Number State |    AZ
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