Individual
DR. STEPHEN LAKE STEPHENSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
1250 MERRY ST, AUGUSTA, GA 30904-3845
(706) 738-6102
(706) 736-6799
Mailing address
1250 MERRY ST, AUGUSTA, GA 30904-3845
(706) 738-6102
(706) 736-6799
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
001603
GA
Other
Enumeration date
03/17/2007
Last updated
07/09/2007
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