Provider Demographics
NPI:1083220693
Name:EURICH, STUART ALLEN
Entity Type:Individual
Prefix:MR
First Name:STUART
Middle Name:ALLEN
Last Name:EURICH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:824 W ROUTE 66 APT 549
Mailing Address - Street 2:
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86001-6588
Mailing Address - Country:US
Mailing Address - Phone:303-709-0117
Mailing Address - Fax:
Practice Address - Street 1:400 W ELM AVE
Practice Address - Street 2:
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86001-1562
Practice Address - Country:US
Practice Address - Phone:928-773-8100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-18
Last Update Date:2020-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer