Provider Demographics
NPI:1083916753
Name:STADNIK AND ASSOCIATES
Entity Type:Organization
Organization Name:STADNIK AND ASSOCIATES
Other - Org Name:VITALITY SPINE AND REHAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:STACY
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:STADNIK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:253-867-2655
Mailing Address - Street 1:124 4TH AVE S STE 110
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98032-5874
Mailing Address - Country:US
Mailing Address - Phone:253-867-2655
Mailing Address - Fax:253-867-5229
Practice Address - Street 1:124 4TH AVE S STE 110
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98032-5874
Practice Address - Country:US
Practice Address - Phone:253-867-2655
Practice Address - Fax:253-867-5229
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-01
Last Update Date:2010-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty