Provider Demographics
NPI:1538548235
Name:STEGMAIER, JAMES THOMAS
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:THOMAS
Last Name:STEGMAIER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3531 JERSEY RIDGE RD APT 318
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52807-2255
Mailing Address - Country:US
Mailing Address - Phone:815-440-6807
Mailing Address - Fax:
Practice Address - Street 1:2965 13TH AVE
Practice Address - Street 2:
Practice Address - City:ROCK ISLAND
Practice Address - State:IL
Practice Address - Zip Code:61201-2814
Practice Address - Country:US
Practice Address - Phone:309-793-4858
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-27
Last Update Date:2015-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038012803111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor