Provider Demographics
NPI:1043585458
Name:ACME SPINE AND NECK CLINIC, LLC
Entity Type:Organization
Organization Name:ACME SPINE AND NECK CLINIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SHAREHOLDER
Authorized Official - Prefix:DR
Authorized Official - First Name:J.W.
Authorized Official - Middle Name:
Authorized Official - Last Name:STUCKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-699-1002
Mailing Address - Street 1:10935 WURZBACH RD STE 103
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78230-2591
Mailing Address - Country:US
Mailing Address - Phone:210-699-1002
Mailing Address - Fax:210-699-0806
Practice Address - Street 1:10935 WURZBACH RD STE 103
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230-2591
Practice Address - Country:US
Practice Address - Phone:210-699-1002
Practice Address - Fax:210-699-0806
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-19
Last Update Date:2012-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty