Provider Demographics
NPI:1689064263
Name:STOULIL, ZACHARY (DC)
Entity Type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:
Last Name:STOULIL
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 1:1376 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:ELDORA
Mailing Address - State:IA
Mailing Address - Zip Code:50627-1631
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1376 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:ELDORA
Practice Address - State:IA
Practice Address - Zip Code:50627-1631
Practice Address - Country:US
Practice Address - Phone:641-939-3831
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-03
Last Update Date:2015-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA076507111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor