Provider Demographics
NPI:1770520850
Name:STANSBURY, JOHN WILLIAM (DC, FIAMA)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:WILLIAM
Last Name:STANSBURY
Suffix:
Gender:M
Credentials:DC, FIAMA
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Mailing Address - Street 1:8522 SIX FORKS RD
Mailing Address - Street 2:STE 101
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-3097
Mailing Address - Country:US
Mailing Address - Phone:919-610-9869
Mailing Address - Fax:919-896-8698
Practice Address - Street 1:8522 SIX FORKS RD
Practice Address - Street 2:STE 101
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-3097
Practice Address - Country:US
Practice Address - Phone:919-896-8715
Practice Address - Fax:919-896-8698
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2016-04-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC3433111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor