Provider Demographics
NPI:1114965613
Name:STITT, STACI M (DC)
Entity Type:Individual
Prefix:DR
First Name:STACI
Middle Name:M
Last Name:STITT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:335 UNITY CENTER RD
Mailing Address - Street 2:
Mailing Address - City:PLUM
Mailing Address - State:PA
Mailing Address - Zip Code:15239
Mailing Address - Country:US
Mailing Address - Phone:412-798-8226
Mailing Address - Fax:412-798-8728
Practice Address - Street 1:335 UNITY CENTER RD
Practice Address - Street 2:
Practice Address - City:PLUM
Practice Address - State:PA
Practice Address - Zip Code:15239
Practice Address - Country:US
Practice Address - Phone:412-798-8226
Practice Address - Fax:412-798-8728
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC007225L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01689283Medicaid
PAGU263046OtherBCBS
PAGU263046OtherBCBS
PA01689283Medicaid