Individual
STEPHEN S ELEDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
2303 RANCH ROAD 620 S STE 190, LAKEWAY, TX 78734-6232
(800) 404-6050
(866) 313-3397
Mailing address
PO BOX 700688, SAN ANTONIO, TX 78270-0688
(800) 404-6050
(866) 313-3397
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
Primary
10686
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10686
CHIROPRACTIC LICENSE
TX
01
—
24803
CHIROPRACTIC LICENSE
CA
Enumeration date
12/13/2006
Last updated
11/30/2023
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