Doctor Name: | STEPHEN R WATERS |
NPI Number: | 1225128945 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DC |
License Number: | 21550 |
Business Practice Address: | 90 E Tasman Dr San Jose, CA - 951341617 |
Business Phone Number: | 4089446000 |
Business Fax Number: | |
Mailing Address: | 1306 Mount Shasta Ave, MILPITAS |
State: | CA |
Postal Code: | 950356931 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 10/13/2006 |
NPI Last Update Date: | 11/01/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 111N00000X |
License Number: | 21550 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Chiropractic Providers |
Taxonomy Classification: | Chiropractor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |