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Individual

JAMIE DEVON STEPHENS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
801 BROADWAY AVE, MATTOON, IL 61938-4211
(217) 234-2800
Mailing address
801 BROADWAY AVE, MATTOON, IL 61938-4211
(217) 234-2800

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038011188
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
038011188
CHIROPRACTOR LICENSE
IL
Enumeration date
06/10/2008
Last updated
02/18/2022
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