| NPI | 1609315571 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK STUBBENDIECK Owner 330-725-4060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: OH 1935) |
| Additional Taxonomies | 111NR0400X Chiropractor, Rehabilitation (Licence: OH 1935) |
| 111NS0005X Chiropractor, Sports Physician (Licence: OH 1935) | |
| Enumeration Date | 2017-02-13 |
| Last Update Date | 2023-09-21 |