Provider Demographics
NPI:1932571874
Name:STUTZ, JACOB (DC, MS)
Entity Type:Individual
Prefix:
First Name:JACOB
Middle Name:
Last Name:STUTZ
Suffix:
Gender:M
Credentials:DC, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9705 HEDGE BELL DR
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-2823
Mailing Address - Country:US
Mailing Address - Phone:832-622-6031
Mailing Address - Fax:
Practice Address - Street 1:8765 STOCKARD DR
Practice Address - Street 2:SUITE 902
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-8600
Practice Address - Country:US
Practice Address - Phone:832-622-6031
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-29
Last Update Date:2015-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13073111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor