Provider Demographics
NPI:1629540620
Name:STACHOWICZ CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:STACHOWICZ CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER/MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEF
Authorized Official - Middle Name:BERNARD
Authorized Official - Last Name:STACHOWICZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:231-215-0518
Mailing Address - Street 1:896 E APPLE AVE
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49442-3738
Mailing Address - Country:US
Mailing Address - Phone:231-773-4716
Mailing Address - Fax:
Practice Address - Street 1:896 E APPLE AVE
Practice Address - Street 2:
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49442-3738
Practice Address - Country:US
Practice Address - Phone:231-773-4716
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-02
Last Update Date:2019-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty