Healthcare Provider Details

I. General information

NPI: 1043451602
Provider Name (Legal Business Name): RYAN J STOOKEY DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/11/2009
Last Update Date: 06/30/2020
Certification Date: 06/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8466 NORTHCLIFFE BLVD
SPRING HILL FL
34606-1140
US

IV. Provider business mailing address

8466 NORTHCLIFFE BLVD
SPRING HILL FL
34606-1140
US

V. Phone/Fax

Practice location:
  • Phone: 352-666-2222
  • Fax: 352-683-7284
Mailing address:
  • Phone: 352-666-2222
  • Fax: 352-683-7284

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH11308
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: