Provider Demographics
NPI:1154521300
Name:DE LA TORRE, STEPHANIE L (DC)
Entity type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:L
Last Name:DE LA TORRE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1854 MINNESOTA AVE
Mailing Address - Street 2:SUITE 4
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66102-4122
Mailing Address - Country:US
Mailing Address - Phone:913-321-8182
Mailing Address - Fax:913-321-8186
Practice Address - Street 1:1854 MINNESOTA AVE
Practice Address - Street 2:SUITE 4
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66102-4122
Practice Address - Country:US
Practice Address - Phone:913-321-8182
Practice Address - Fax:913-321-8186
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-24
Last Update Date:2007-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-04544111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor