Provider Demographics
NPI:1568583052
Name:QUIGLEY, STEWART MITCHELL (DC)
Entity Type:Individual
Prefix:DR
First Name:STEWART
Middle Name:MITCHELL
Last Name:QUIGLEY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1675 LAKESIDE DR
Mailing Address - Street 2:STE 103
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-3421
Mailing Address - Country:US
Mailing Address - Phone:775-322-5704
Mailing Address - Fax:775-322-8297
Practice Address - Street 1:1675 LAKESIDE DR
Practice Address - Street 2:STE 103
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-3421
Practice Address - Country:US
Practice Address - Phone:775-322-5704
Practice Address - Fax:775-322-8297
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2018-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB01245111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV103766OtherMEDICARE PTAN