Provider Demographics
NPI:1528717709
Name:STEWART SPORTS CHIROPRACTIC & WELLNESS, PC
Entity type:Organization
Organization Name:STEWART SPORTS CHIROPRACTIC & WELLNESS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:C
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:912-352-8051
Mailing Address - Street 1:116 OGLETHORPE PROFESSIONAL CT UNIT A
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-3623
Mailing Address - Country:US
Mailing Address - Phone:912-352-8051
Mailing Address - Fax:912-352-8076
Practice Address - Street 1:116 OGLETHORPE PROFESSIONAL CT UNIT A
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-3623
Practice Address - Country:US
Practice Address - Phone:912-352-8051
Practice Address - Fax:912-352-8076
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-23
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty