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General NPI Number Information
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NPI Number | 1134241102
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Entity Type | Individual
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Provider Name | GEORGE RICHARD STUBBLEFIELD D.C.
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Gender | Male
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Dates
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Enumeration Date | 04/03/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2550 DOUGLAS BLVD
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City | ROSEVILLE
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State | CA
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Zip | 95661-3996
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Country | US
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Telephone | 916-788-2929
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Fax | 916-784-9577
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Provider Business Mailing Address
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Address Line | 2109 DARK CANYON DR
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City | GOLD RIVER
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State | CA
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Zip | 95670-8141
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Country | US
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Telephone | 916-788-2929
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Fax | 916-784-9577
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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 | 11526
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License Number State | CA
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