Individual
DR. STACY ALLEN CHIDESTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
5144 COLLEGE CORNER PIKE, OXFORD, OH 45056-1068
(513) 524-4800
(513) 523-8631
Mailing address
5144 COLLEGE CORNER PIKE STE A, OXFORD, OH 45056-1068
(513) 524-4800
(513) 523-8631
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2292
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000074780
ANTHEM
OH
Enumeration date
04/05/2006
Last updated
10/23/2023
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