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General NPI Number Information
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NPI Number | 1023296654
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Entity Type | Organization
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Legal Business Name | STULL CHIROPRACTIC PLC
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Dates
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Enumeration Date | 02/06/2008
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Last Update Date | 03/20/2009
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Provider Practice Location Address
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Address Line | 2820 NILES RD
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City | SAINT JOSEPH
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State | MI
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Zip | 49085-3355
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Country | US
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Telephone | 269-429-1982
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Fax |
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Provider Business Mailing Address
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Address Line | 2820 NILES RD
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City | SAINT JOSEPH
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State | MI
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Zip | 49085-3355
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Country | US
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Telephone | 269-429-1982
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Fax |
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Authorized Official
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Title or Position | DOCTOR / PRESIDENT
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Name | DR. KATHLYNN STULL
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Credential | DC
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Telephone | 269-429-1982
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 2301008480
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License Number State | MI
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