Provider Demographics
NPI:1174750327
Name:STELLA, ANDREW J (DC)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:J
Last Name:STELLA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:MR
Other - First Name:ANDREW
Other - Middle Name:J
Other - Last Name:STELLA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:125 MAIN ST SE STE 237
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55414-2278
Mailing Address - Country:US
Mailing Address - Phone:612-378-9355
Mailing Address - Fax:
Practice Address - Street 1:125 MAIN ST SE STE 237
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55414-2278
Practice Address - Country:US
Practice Address - Phone:612-378-9355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-15
Last Update Date:2009-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2547111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor