Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | CH2378 | MA |
N | 111NP0017X | Pediatric Chiropractor | CH2378 | MA |
NPI | 1386963395 |
---|---|
Provider Name | Dr. Kristine Stockfisch |
First Address | Great Barrington, MA 01230-1233 |
Second Address | Great Barrington, MA 01230-1233 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2010 |
Last Update Date | 01/06/2010 |