MEDICARE: DAVID A STELLA DC PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	95695	NV

General Provider Information

NPI Number	:	1013100981
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAVID A STELLA DC PC

Provider Business Mailing Address
First Line	:	375 N STEPHANIE ST
Second Line	:	STE 1213
City	:	HENDERSON
State	:	NV
Zip	:	89014-8771
Country	:	US
Telephone Number	:	702-932-1798
Fax Number	:	702-446-8382

Provider Business Practice Location Address
First Line	:	375 N STEPHANIE ST
Second Line	:	STE 1213
City	:	HENDERSON
State	:	NV
Zip	:	89014-8771
Country	:	US
Telephone Number	:	702-932-1798
Fax Number	:	702-446-8382

Authorized Official
Title or Position	:	OWNER
Name	:	DAVID STELLA
Credential	:	DC
Telephone Number	:	702-932-1798

Provider Enumeration Date	:	08/23/2007
Last Update Date	:	08/23/2007

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