Provider Demographics
NPI:1386963395
Name:STOCKFISCH, KRISTINE (DC)
Entity type:Individual
Prefix:DR
First Name:KRISTINE
Middle Name:
Last Name:STOCKFISCH
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:KRISTINE
Other - Middle Name:
Other - Last Name:OLSEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:405 STOCKBRIDGE RD
Mailing Address - Street 2:C/O VITALITY CHIROPRACTIC
Mailing Address - City:GREAT BARRINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01230-1233
Mailing Address - Country:US
Mailing Address - Phone:413-644-6402
Mailing Address - Fax:
Practice Address - Street 1:405 STOCKBRIDGE RD
Practice Address - Street 2:C/O VITALITY CHIROPRACTIC
Practice Address - City:GREAT BARRINGTON
Practice Address - State:MA
Practice Address - Zip Code:01230-1233
Practice Address - Country:US
Practice Address - Phone:413-644-6402
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-01
Last Update Date:2010-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MACH2378111N00000X, 111NP0017X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NP0017XChiropractic ProvidersChiropractorPediatric Chiropractor