Individual
TERI L STOCKWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
1415 BARCLAY CIR SE, MARIETTA, GA 30060-2943
(770) 426-2786
(770) 792-6113
Mailing address
1415 BARCLAY CIR SE, MARIETTA, GA 30060-2943
(770) 426-2786
(770) 792-6113
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
2301007022
MI
111N00000X
Chiropractor
Primary
CHIR009030
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3144040
—
MI
01
—
950B810180
BCBS GROUP NUMBER
MI
01
—
950B852340
BCBS INDIVIDUAL ID NUMBER
MI
01
—
G05544
BCN GROUP NUMBER
MI
01
—
P101464
BCN INDIVIDUAL PIN NUMBER
MI
Enumeration date
02/14/2007
Last updated
04/08/2021
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