NPI 1669521324 · live from the CMS NPI Registry
Stephan Paul Ediss, D.C.
Chiropractor in Douglas, WY. National Provider Identifier 1669521324, active.
NPI record
| NPI | 1669521324 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Chiropractor 111N00000X |
| Practice location | 1330 E. Richards, Douglas, WY 82633 |
| Practice phone | 307-358-3147 |
| Mailing address | Po Box 902, 1330 E. Richards, Douglas, WY 82633 |
| Enumerated | January 10, 2007 |
| Last updated | January 20, 2021 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Chiropractor primary | 111N00000X | 574 (WY) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.