Provider Demographics
NPI:1720149230
Name:STUBBS, WESLEY (DC)
Entity Type:Individual
Prefix:DR
First Name:WESLEY
Middle Name:
Last Name:STUBBS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:146 ANOKA AVE
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:RI
Mailing Address - Zip Code:02806-3428
Mailing Address - Country:US
Mailing Address - Phone:401-289-0155
Mailing Address - Fax:401-289-2302
Practice Address - Street 1:146 ANOKA AVE
Practice Address - Street 2:
Practice Address - City:BARRINGTON
Practice Address - State:RI
Practice Address - Zip Code:02806-3428
Practice Address - Country:US
Practice Address - Phone:401-289-0155
Practice Address - Fax:401-289-2302
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2008-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3104111N00000X
CADC30042111N00000X
RIDCP00574111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor