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General NPI Number Information
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NPI Number | 1811986425
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Entity Type | Organization
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Legal Business Name | STUCKY CHIROPRACTIC CENTER SC
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Dates
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Enumeration Date | 10/17/2005
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 2105 E CLAIREMONT AVE
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City | EAU CLAIRE
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State | WI
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Zip | 54701-4768
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Country | US
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Telephone | 715-835-9514
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Fax | 715-835-2602
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Provider Business Mailing Address
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Address Line | 2105 E CLAIREMONT AVE
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City | EAU CLAIRE
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State | WI
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Zip | 54701-4768
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Country | US
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Telephone | 715-835-9514
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Fax | 715-835-2602
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. JAY LAGUARDIA
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Credential | DC
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Telephone | 715-835-9514
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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 |
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License Number State |
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