Provider Demographics
NPI:1447203427
Name:STADTHER CHIROPRACTIC, LTD
Entity Type:Organization
Organization Name:STADTHER CHIROPRACTIC, LTD
Other - Org Name:MERIDIAN DISC INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:STADTHER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:320-214-0044
Mailing Address - Street 1:3305 EAGLE RIDGE DR E
Mailing Address - Street 2:
Mailing Address - City:WILLMAR
Mailing Address - State:MN
Mailing Address - Zip Code:56201-8735
Mailing Address - Country:US
Mailing Address - Phone:320-214-0006
Mailing Address - Fax:
Practice Address - Street 1:205 5TH ST SW
Practice Address - Street 2:
Practice Address - City:WILLMAR
Practice Address - State:MN
Practice Address - Zip Code:56201-3211
Practice Address - Country:US
Practice Address - Phone:320-214-0044
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty