Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 8224 | TX |
NPI | 1164555850 |
---|---|
Provider Name | Samuela C Stankovic |
First Address | Plano, TX 75024-3795 |
Second Address | Rockwall, TX 75032-5803 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/03/2007 |
Last Update Date | 08/07/2007 |