Provider Demographics
NPI:1952458200
Name:STOLTZ, INSON (DC)
Entity Type:Individual
Prefix:DR
First Name:INSON
Middle Name:
Last Name:STOLTZ
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 1:1504 PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:FT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76104-2027
Mailing Address - Country:US
Mailing Address - Phone:817-335-4878
Mailing Address - Fax:817-335-4890
Practice Address - Street 1:1504 PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:FT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-2027
Practice Address - Country:US
Practice Address - Phone:817-335-4878
Practice Address - Fax:817-335-4890
Is Sole Proprietor?:No
Enumeration Date:2007-01-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8925111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor