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General NPI Number Information
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NPI Number | 1063712305
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Entity Type | Individual
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Provider Name | KRISTEN L. STAULA D.C.
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Gender | Female
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Dates
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Enumeration Date | 11/02/2010
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Last Update Date | 08/13/2013
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Provider Practice Location Address
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Address Line | 250 COPELAND ST
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City | QUINCY
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State | MA
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Zip | 02169-4073
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Country | US
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Telephone | 617-328-0839
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Fax | 617-328-8885
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Provider Business Mailing Address
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Address Line | 31 VILLAGE WEST TRL
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City | PLYMOUTH
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State | MA
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Zip | 02360-7501
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Country | US
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Telephone | 603-661-0101
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 3291
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License Number State | MA
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