Provider Demographics
NPI:1114938636
Name:STONECREEK CHIROPRACTIC
Entity Type:Organization
Organization Name:STONECREEK CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JACQUE
Authorized Official - Middle Name:
Authorized Official - Last Name:KEIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-557-2982
Mailing Address - Street 1:2200 MORRISS RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028-3521
Mailing Address - Country:US
Mailing Address - Phone:972-874-7554
Mailing Address - Fax:972-874-7553
Practice Address - Street 1:2200 MORRISS RD
Practice Address - Street 2:SUITE 200
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-3521
Practice Address - Country:US
Practice Address - Phone:972-874-7554
Practice Address - Fax:972-874-7553
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2007-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty