Individual
CHAD ALLEN STADSVOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2800 PIERCE ST, SUITE 110, SIOUX CITY, IA 51104-3755
(712) 279-3754
(712) 279-3644
Mailing address
2800 PIERCE ST, SUITE 110, SIOUX CITY, IA 51104-3755
(712) 279-3754
(712) 279-3644
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
R8139
IA
208100000X
Physical Medicine & Rehabilitation Physician
Primary
4175
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00606
—
IA
Enumeration date
06/19/2007
Last updated
07/27/2015
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