Provider Demographics
NPI:1326505157
Name:STUMP, JACOB C (DC)
Entity type:Individual
Prefix:DR
First Name:JACOB
Middle Name:C
Last Name:STUMP
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:69500 COUNTY ROAD 3
Mailing Address - Street 2:
Mailing Address - City:NAPPANEE
Mailing Address - State:IN
Mailing Address - Zip Code:46550-9010
Mailing Address - Country:US
Mailing Address - Phone:574-849-1360
Mailing Address - Fax:
Practice Address - Street 1:69500 COUNTY ROAD 3 # 2
Practice Address - Street 2:
Practice Address - City:NAPPANEE
Practice Address - State:IN
Practice Address - Zip Code:46550-9010
Practice Address - Country:US
Practice Address - Phone:574-849-1360
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-28
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN35802222012255A2300X
IN08003492A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN3580222201Other22 RESPIRATORY, DEVELOPMENTAL, REHABILITATIVE SERVICES PROVIDER