Provider Demographics
NPI:1306333158
Name:STOAKES, THERESA ANN (DC)
Entity type:Individual
Prefix:DR
First Name:THERESA
Middle Name:ANN
Last Name:STOAKES
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4709 CREST HILL DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33615-4514
Mailing Address - Country:US
Mailing Address - Phone:317-625-4070
Mailing Address - Fax:
Practice Address - Street 1:32976 US HIGHWAY 19 N
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34684-3122
Practice Address - Country:US
Practice Address - Phone:727-787-6677
Practice Address - Fax:727-787-1177
Is Sole Proprietor?:No
Enumeration Date:2018-04-17
Last Update Date:2018-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH12418111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor