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Individual

JOHN WILLIAMS STEVENS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
330 NORTHERN BOULEVARD, SUITE 447, CHINCHILLA, PA 18410
(570) 586-0707
(570) 587-5979
Mailing address
PO BOX 447, RT. 6 & 11 NORTHERN BLVD., CHINCHILLA, PA 18410-0447
(570) 586-0707
(570) 587-5979

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
AJ-005225-L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
479811
BLUE SHIELD
PA
01
804331
FIRST PRIORITY
PA
Enumeration date
09/06/2006
Last updated
07/08/2007
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