Provider Demographics
NPI:1598487332
Name:100 CHIRO STEWART, PLLC
Entity Type:Organization
Organization Name:100 CHIRO STEWART, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:770-756-3612
Mailing Address - Street 1:5851 SCOTTSVILLE RD STE 202
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42104-7973
Mailing Address - Country:US
Mailing Address - Phone:770-756-3612
Mailing Address - Fax:
Practice Address - Street 1:5833 SCOTTSVILLE RD STE 202
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42104-7853
Practice Address - Country:US
Practice Address - Phone:770-756-3612
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-19
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty