Provider Demographics
NPI:1760775852
Name:STEWART, ZOILA ROSA (DC)
Entity Type:Individual
Prefix:DR
First Name:ZOILA
Middle Name:ROSA
Last Name:STEWART
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 1:1374 PAIR ST SE
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30008-3807
Mailing Address - Country:US
Mailing Address - Phone:678-895-0156
Mailing Address - Fax:
Practice Address - Street 1:1374 PAIR ST SE
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30008-3807
Practice Address - Country:US
Practice Address - Phone:678-895-0156
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-23
Last Update Date:2012-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA008354111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician