MEDICARE: DR. DENNIS SCOTT STACHELEK D.C.

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
1	111N00000X	Chiropractor	0104001998	VA

General Provider Information

NPI Number	:	1811166051
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DENNIS SCOTT STACHELEK D.C.

Provider Business Mailing Address
First Line	:	5069 WATERWAY DR
Second Line	:
City	:	DUMFRIES
State	:	VA
Zip	:	22025-1259
Country	:	US
Telephone Number	:	703-580-8388
Fax Number	:	703-580-8628

Provider Business Practice Location Address
First Line	:	5069 WATERWAY DR
Second Line	:
City	:	DUMFRIES
State	:	VA
Zip	:	22025-1259
Country	:	US
Telephone Number	:	703-580-8388
Fax Number	:	703-580-8628

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/21/2008
Last Update Date	:	02/21/2008

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