Provider Demographics
NPI:1851839369
Name:STICKLE ENTERPRISES
Entity Type:Organization
Organization Name:STICKLE ENTERPRISES
Other - Org Name:DISC CENTER OF AMERICA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TRAVIS
Authorized Official - Middle Name:N
Authorized Official - Last Name:STICKLE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:434-262-1739
Mailing Address - Street 1:20370A TIMBERLAKE RD
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24502-7213
Mailing Address - Country:US
Mailing Address - Phone:434-262-1739
Mailing Address - Fax:
Practice Address - Street 1:20370A TIMBERLAKE RD
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24502-7213
Practice Address - Country:US
Practice Address - Phone:434-262-1739
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-03
Last Update Date:2017-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104555954111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty