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NPI Code Detail

MEDICARE: STILLWATER HEALTH AND WELLNESS LLC

MEDICARE: STILLWATER HEALTH AND WELLNESS LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor38MC00455900NJ

General Provider Information

NPI Number : 1649545625
Entity Type Code : Organization
Provider Name (Legal Business Name) : STILLWATER HEALTH AND WELLNESS LLC
Provider Business Mailing Address
First Line : 18 STILLWATER RD
Second Line :
City : BLAIRSTOWN
State : NJ
Zip : 07825-9561
Country : US
Telephone Number : 908-362-8767
Fax Number : 908-362-8770
Provider Business Practice Location Address
First Line : 18 STILLWATER RD
Second Line :
City : BLAIRSTOWN
State : NJ
Zip : 07825-9561
Country : US
Telephone Number : 908-362-8767
Fax Number : 908-362-8770
Authorized Official
Title or Position : OWNER
Name : DR. SANDY GIACOBBE JR.
Credential : D.C.
Telephone Number : 908-362-8767
Provider Enumeration Date : 03/09/2012
Last Update Date : 03/09/2012

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Directions to “STILLWATER HEALTH AND WELLNESS LLC ” Practice Location

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