Provider Demographics
NPI:1861700569
Name:STEPHENS, MICHAEL JOSHUA (DC)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:JOSHUA
Last Name:STEPHENS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 SW 15TH ST
Mailing Address - Street 2:
Mailing Address - City:OKEECHOBEE
Mailing Address - State:FL
Mailing Address - Zip Code:34974-5260
Mailing Address - Country:US
Mailing Address - Phone:863-202-0031
Mailing Address - Fax:
Practice Address - Street 1:295 SOUTHWEST PLZ
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76016-4455
Practice Address - Country:US
Practice Address - Phone:863-202-0031
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-16
Last Update Date:2016-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9803111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor