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General NPI Number Information
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NPI Number | 1902178395
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Entity Type | Organization
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Legal Business Name | J. MICHAEL STOLLEY, D.C., P.A.
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Dates
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Enumeration Date | 02/01/2012
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Last Update Date | 02/01/2012
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Provider Practice Location Address
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Address Line | 12122 SEMINOLE BLVD
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City | LARGO
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State | FL
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Zip | 33778-2833
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Country | US
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Telephone | 727-584-3386
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Fax | 727-581-8619
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Provider Business Mailing Address
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Address Line | 12122 SEMINOLE BLVD
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City | LARGO
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State | FL
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Zip | 33778-2833
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Country | US
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Telephone | 727-584-3386
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Fax | 727-581-8619
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Authorized Official
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Title or Position | DOCTOR OF CHIROPRACTIC
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Name | DR. J. MICHAEL STOLLEY
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Credential | D.C.
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Telephone | 727-584-3386
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | CH3042
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License Number State | FL
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