Organization
MARK J STUBBENDIECK DC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK STUBBENDIECK DC (OWNER)
(330) 725-4060
Entity
Organization
Contact information
Practice address
780 E SMITH RD # A, MEDINA, OH 44256-2662
(330) 725-4060
(330) 722-4582
Mailing address
780 E SMITH RD # A, MEDINA, OH 44256-2662
(133) 072-5406
(330) 722-4582
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1935
OH
111NR0400X
Rehabilitation Chiropractor
1935
OH
111NS0005X
Sports Physician Chiropractor
1935
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2657665
—
OH
Enumeration date
02/13/2017
Last updated
09/21/2023
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