Provider Demographics
NPI:1114246238
Name:STADLER, PAUL A (DC)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:A
Last Name:STADLER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10965 S. RIVER FRONT PKWY
Mailing Address - Street 2:
Mailing Address - City:SOUTH JORDON
Mailing Address - State:UT
Mailing Address - Zip Code:84095
Mailing Address - Country:US
Mailing Address - Phone:801-446-2822
Mailing Address - Fax:801-416-1861
Practice Address - Street 1:10965 S. RIVER FRONT PKWY
Practice Address - Street 2:
Practice Address - City:SOUTH JORDON
Practice Address - State:UT
Practice Address - Zip Code:84095
Practice Address - Country:US
Practice Address - Phone:801-446-2822
Practice Address - Fax:801-416-1861
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-28
Last Update Date:2019-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDCHIA-1409111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor