MEDICARE: GREGORY STERN DC, LAC

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	0104557141	VA
2	171100000X	Acupuncturist	0104557141	VA

General Provider Information

NPI Number	:	1427475680
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GREGORY STERN DC, LAC

Provider Business Mailing Address
First Line	:	555 MASON AVE
Second Line	:
City	:	CAPE CHARLES
State	:	VA
Zip	:	23310-3301
Country	:	US
Telephone Number	:	757-695-3840
Fax Number	:

Provider Business Practice Location Address
First Line	:	555 MASON AVE
Second Line	:
City	:	CAPE CHARLES
State	:	VA
Zip	:	23310-3301
Country	:	US
Telephone Number	:	757-695-3840
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/26/2014
Last Update Date	:	09/17/2014

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Directions to “ GREGORY STERN DC, LAC” Practice Location

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