Provider Demographics
NPI:1518422468
Name:STEWART CHIROPRACTIC & WELLNESS, LLC
Entity Type:Organization
Organization Name:STEWART CHIROPRACTIC & WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:A
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:DC, CERTIFIED IN ACU
Authorized Official - Phone:813-946-6283
Mailing Address - Street 1:1548 BLOOMINGDALE AVE
Mailing Address - Street 2:
Mailing Address - City:VALRICO
Mailing Address - State:FL
Mailing Address - Zip Code:33596-6101
Mailing Address - Country:US
Mailing Address - Phone:813-946-6283
Mailing Address - Fax:
Practice Address - Street 1:1548 BLOOMINGDALE AVE
Practice Address - Street 2:
Practice Address - City:VALRICO
Practice Address - State:FL
Practice Address - Zip Code:33596-6101
Practice Address - Country:US
Practice Address - Phone:813-946-6283
Practice Address - Fax:813-322-2508
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-05
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty