MEDICARE: STEVENS CHIROPRACTIC, LLC

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	38MC00560300	NJ

General Provider Information

NPI Number	:	1487034898
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STEVENS CHIROPRACTIC, LLC

Provider Business Mailing Address
First Line	:	8 COURT HOUSE SOUTH DENNIS ROAD
Second Line	:
City	:	CAPE MAY COURT HOUSE
State	:	NJ
Zip	:	08210-3134
Country	:	US
Telephone Number	:	609-463-4590
Fax Number	:	609-463-4591

Provider Business Practice Location Address
First Line	:	8 COURT HOUSE SOUTH DENNIS RD
Second Line	:
City	:	CAPE MAY COURT HOUSE
State	:	NJ
Zip	:	08210-1967
Country	:	US
Telephone Number	:	609-463-4590
Fax Number	:	609-463-4591

Authorized Official
Title or Position	:	CHIROPRACTOR
Name	:	DR. SHEILA ISABELLA STEVENS
Credential	:	D.C,
Telephone Number	:	609-638-6181

Provider Enumeration Date	:	06/02/2015
Last Update Date	:	05/27/2016

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