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General NPI Number Information
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NPI Number | 1629062047
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Entity Type | Individual
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Provider Name | JOHN STAUB D.C.
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Gender | Male
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Dates
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Enumeration Date | 08/31/2005
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Last Update Date | 01/10/2017
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Provider Practice Location Address
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Address Line | 615 HERNDON AVE SUITE G
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City | ORLANDO
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State | FL
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Zip | 32803-5138
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Country | US
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Telephone | 407-228-9599
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Fax | 800-440-0693
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Provider Business Mailing Address
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Address Line | 615 HERNDON AVE SUITE G
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City | ORLANDO
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State | FL
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Zip | 32803-5138
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Country | US
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Telephone | 407-228-9599
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Fax | 800-440-0693
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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 | CH8270
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License Number State | FL
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