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General NPI Number Information
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NPI Number | 1720262280
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Entity Type | Organization
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Legal Business Name | STASZ CHIROPRACTIC, P.C.
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Dates
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Enumeration Date | 12/19/2007
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Last Update Date | 12/19/2007
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Provider Practice Location Address
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Address Line | 1514 ISETT AVE
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City | MUSCATINE
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State | IA
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Zip | 52761-4669
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Country | US
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Telephone | 563-263-2134
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Fax | 563-263-6562
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Provider Business Mailing Address
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Address Line | 1514 ISETT AVE
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City | MUSCATINE
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State | IA
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Zip | 52761-4669
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Country | US
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Telephone | 563-263-2134
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Fax | 563-263-6562
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARK ANDREW STASZ
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Credential | D.C.
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Telephone | 563-263-2134
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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 | 06306
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License Number State | IA
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