Provider Demographics
NPI:1487012555
Name:JACOB STUTZ, DC, LLC
Entity Type:Organization
Organization Name:JACOB STUTZ, DC, LLC
Other - Org Name:FRISCO FAMILY & SPORTS CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SOLE MBR
Authorized Official - Prefix:DR
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:A
Authorized Official - Last Name:STUTZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:972-294-5534
Mailing Address - Street 1:8765 STOCKARD DR
Mailing Address - Street 2:SUITE 902
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-8600
Mailing Address - Country:US
Mailing Address - Phone:972-294-5534
Mailing Address - Fax:
Practice Address - Street 1:8765 STOCKARD DR
Practice Address - Street 2:SUITE 902
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-8600
Practice Address - Country:US
Practice Address - Phone:972-294-5534
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-04
Last Update Date:2016-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13073111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty