Provider Demographics
NPI:1770525800
Name:STICKLE, ERIC R (DC)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:R
Last Name:STICKLE
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 1:20370 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:434-239-2243
Mailing Address - Fax:434-239-5374
Practice Address - Street 1:20370 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:434-239-2243
Practice Address - Fax:434-239-5374
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2016-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104555600111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition