Individual
DR. STEPHEN RAY TIETJEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
5636 HAVANA DR, NORTH RICHLAND HILLS, TX 76180-6558
(817) 991-6428
Mailing address
5636 HAVANA DR., NORTH RICHLAND HILLS, TX 76180
(817) 991-6428
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
12018
TX
111NR0400X
Rehabilitation Chiropractor
Primary
12018
TX
Other
Enumeration date
07/02/2012
Last updated
07/02/2012
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