Organization
MARK J STUBBENDIECK DC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
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
197 N PARDEE ST, WADSWORTH, OH 44281-1541
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1935
OH
111NR0400X
Rehabilitation Chiropractor
1935
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2657665
—
OH
Enumeration date
04/27/2012
Last updated
05/12/2023
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