Doctor Name: | STEPHEN LEWIS CHILDRESS |
NPI Number: | 1285684332 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DC |
License Number: | 0104001354 |
Business Practice Address: | 619 W Main St Ste B Lebanon, VA - 242663809 |
Business Phone Number: | 2768891314 |
Business Fax Number: | 2768894125 |
Mailing Address: | Po Box 1300, 619 W Main Street Suite B LEBANON |
State: | VA |
Postal Code: | 242661300 |
Phone Number: | 2768891314 |
Fax Number: | 2768894125 |
NPI Enumeration Date: | 05/11/2006 |
NPI Last Update Date: | 04/17/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 111N00000X |
License Number: | 0104001354 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
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. |