# MARK J STUBBENDIECK DC INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1871869289
- **Authorized official:** DR. MARK STUBBENDIECK DC (OWNER)
- **Authorized official phone:** (330) 725-4060

## Contact information

- **Practice address:** 257 S COURT ST, STE 5A, MEDINA, OH 44256-2295
- **Practice address phone:** (330) 725-4060
- **Mailing address:** 257 S COURT ST, STE 5A, MEDINA, OH 44256-2295

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | 1935 | OH | Yes |

## Other

- **Enumeration date:** 03/29/2012
- **Last updated:** 04/19/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 2657665 | — | OH |