Provider Demographics
NPI:1285276543
Name:STONE OAK CHIROPRACTIC
Entity type:Organization
Organization Name:STONE OAK CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TINA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAU
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:210-545-2001
Mailing Address - Street 1:510 MED CT STE 207
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-3484
Mailing Address - Country:US
Mailing Address - Phone:210-545-2001
Mailing Address - Fax:210-545-2168
Practice Address - Street 1:510 MED CT STE 207
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-3484
Practice Address - Country:US
Practice Address - Phone:210-545-2001
Practice Address - Fax:210-545-2168
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-08
Last Update Date:2020-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty