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General NPI Number Information
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NPI Number | 1770069932
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Entity Type | Individual
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Provider Name | JUSTIN RANDALL STIFFLER L. AC.
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Gender | Male
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Dates
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Enumeration Date | 07/11/2018
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Last Update Date | 07/11/2018
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Provider Practice Location Address
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Address Line | 8517 E OAK ISLAND DR
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City | OAK ISLAND
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State | NC
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Zip | 28465-8052
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Country | US
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Telephone | 910-833-0766
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Fax | 888-447-0823
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Provider Business Mailing Address
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Address Line | 8517 E OAK ISLAND DR
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City | OAK ISLAND
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State | NC
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Zip | 28465-8052
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Country | US
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Telephone | 910-833-0766
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Fax | 888-447-0823
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 760
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License Number State | NC
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