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General NPI Number Information
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NPI Number | 1386777324
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Entity Type | Organization
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Legal Business Name | STASIO CHIROPRACTIC CENTER P.C.
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Dates
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Enumeration Date | 03/13/2007
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Last Update Date | 09/30/2010
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Provider Practice Location Address
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Address Line | 26000 HOOVER RD SUITE 110 STASIO CHIROPRACTIC CENTER
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City | WARREN
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State | MI
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Zip | 48089
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Country | US
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Telephone | 586-757-6285
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Fax | 586-757-6290
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Provider Business Mailing Address
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Address Line | 26000 HOOVER RD SUITE 110
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City | WARREN
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State | MI
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Zip | 48089
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Country | US
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Telephone | 586-757-6285
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Fax | 586-757-6290
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Authorized Official
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Title or Position | BUSINESS OWNER
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Name | MR. CRAIG ALLEN STASIO
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Credential | DC
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Telephone | 586-757-6285
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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 | 2301007308
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License Number State | MI
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