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General NPI Number Information
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NPI Number | 1073855086
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Entity Type | Organization
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Legal Business Name | STOUT FAMILY CHIROPRACTIC, P.A.
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Dates
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Enumeration Date | 03/18/2013
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Last Update Date | 12/08/2016
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Provider Practice Location Address
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Address Line | 10956 N 56TH ST 201
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City | TEMPLE TERRACE
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State | FL
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Zip | 33617-3008
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Country | US
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Telephone | 813-701-7272
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Fax | 813-501-1081
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Provider Business Mailing Address
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Address Line | PO BOX 290285
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City | TAMPA
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State | FL
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Zip | 33687-0285
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Country | US
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Telephone | 813-701-7272
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ADAM STOUT
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Credential | D.C.
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Telephone | 813-787-6764
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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 | CH10219
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH9983
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License Number State | FL
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