Individual
DR. STEPHAN MARK DEHAVEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
1060 CENTERVILLE CIR, SAINT PAUL, MN 55127-6344
(651) 429-3015
(651) 653-3832
Mailing address
1060 CENTERVILLE CIR, SAINT PAUL, MN 55127-6344
(651) 429-3015
(651) 653-3832
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2585
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
59969DE
MINNESOTA
MN
Enumeration date
04/24/2007
Last updated
07/08/2007
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