Provider Demographics
NPI:1831144450
Name:STADTHER CHIROPRACTIC, LTD.
Entity Type:Organization
Organization Name:STADTHER CHIROPRACTIC, LTD.
Other - Org Name:MERIDIAN DISC INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:J
Authorized Official - Last Name:STADTHER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:320-202-0577
Mailing Address - Street 1:3337 W SAINT GERMAIN ST
Mailing Address - Street 2:SUITE #109
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56301-8503
Mailing Address - Country:US
Mailing Address - Phone:320-202-0577
Mailing Address - Fax:320-202-0578
Practice Address - Street 1:3337 W SAINT GERMAIN ST
Practice Address - Street 2:SUITE #109
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56301-8503
Practice Address - Country:US
Practice Address - Phone:320-202-0577
Practice Address - Fax:320-202-0578
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty