Organization
LIFE CHIROPRACTIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIMOTHY MICHAEL STACKIS DC (CHIROPRACTOR)
(563) 582-0300
Entity
Organization
Contact information
Practice address
2454 MEINEN CT, DUBUQUE, IA 52002
(563) 582-0300
Mailing address
2454 MEINEN CT, DUBUQUE, IA 52002
(563) 582-0300
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
06739
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0469346
—
IA
Enumeration date
02/12/2008
Last updated
02/04/2011
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