Provider Demographics
NPI:1588020333
Name:STOBERT, JULIA (DC)
Entity Type:Individual
Prefix:DR
First Name:JULIA
Middle Name:
Last Name:STOBERT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6470 MAIN ST STE 2
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-5851
Mailing Address - Country:US
Mailing Address - Phone:716-580-3577
Mailing Address - Fax:
Practice Address - Street 1:6470 MAIN ST STE 2
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-5851
Practice Address - Country:US
Practice Address - Phone:716-580-3577
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-10
Last Update Date:2019-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012768111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor