Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 2211 | OH |
NPI | 1003341579 |
---|---|
Provider Name | Dr. Brian Todd Stukey |
First Address | Bexley, OH 43209-1470 |
Second Address | Bexley, OH 43209-1470 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/04/2017 |
Last Update Date | 21/04/2017 |