Provider Demographics
NPI:1982201216
Name:HUBBARD, STANLEY JAMES (LICENSED ACUPUNCTURI)
Entity Type:Individual
Prefix:MR
First Name:STANLEY
Middle Name:JAMES
Last Name:HUBBARD
Suffix:
Gender:M
Credentials:LICENSED ACUPUNCTURI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 STONERIDGE DR.
Mailing Address - Street 2:SUITE 103
Mailing Address - City:WAYNESBORO
Mailing Address - State:VA
Mailing Address - Zip Code:22980-4812
Mailing Address - Country:US
Mailing Address - Phone:540-551-6219
Mailing Address - Fax:
Practice Address - Street 1:27 STONERIDGE DR.
Practice Address - Street 2:SUITE 103
Practice Address - City:WAYNESBORO
Practice Address - State:VA
Practice Address - Zip Code:22980-4812
Practice Address - Country:US
Practice Address - Phone:540-551-6219
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-09
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0121000871171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty