Provider Demographics
NPI:1508929589
Name:STUMBAUGH INC
Entity Type:Organization
Organization Name:STUMBAUGH INC
Other - Org Name:NORWALK CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JESSE
Authorized Official - Middle Name:ROY
Authorized Official - Last Name:STUMBAUGH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:515-981-9208
Mailing Address - Street 1:1300 SUNSET DR
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:IA
Mailing Address - Zip Code:50211-2401
Mailing Address - Country:US
Mailing Address - Phone:515-981-9208
Mailing Address - Fax:515-981-1155
Practice Address - Street 1:1300 SUNSET DR
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:IA
Practice Address - Zip Code:50211
Practice Address - Country:US
Practice Address - Phone:515-981-9208
Practice Address - Fax:515-981-1155
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-19
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06776111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0701378Medicaid