Individual
ROBERT WAYNE STEVENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
368 W PIKE ST, SUITE 202, LAWRENCEVILLE, GA 30045-3240
(770) 963-1918
(678) 817-0330
Mailing address
368 W PIKE ST, SUITE 202, LAWRENCEVILLE, GA 30045-3240
(770) 963-1918
(678) 817-0330
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIRO06793
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
52820948002
BC/BS PROVIDER I.D.
GA
Enumeration date
07/03/2006
Last updated
08/22/2008
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