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Organization
GARY K STOLTZ, D.C., P.A.
Active
Organization
GARY K STOLTZ, D.C., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY KENT STOLTZ DC (OWNER)
(352) 357-7955
Entity
Organization
Contact information
Practice address
2105 PREVATT ST, EUSTIS, FL 32726-6131
(352) 357-7955
(352) 357-7254
Mailing address
2105 PREVATT ST, EUSTIS, FL 32726-6131
(352) 357-7955
(352) 357-7254
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH2081
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
350907427
RR MEDICARE
FL
05
—
380263900
—
FL
01
—
CH2081
STATE LICENCE ID- WORK COMP
FL
Enumeration date
11/09/2011
Last updated
11/09/2011
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