Provider Demographics
NPI:1962972927
Name:STAPLES, EMILY D (DC)
Entity type:Individual
Prefix:DR
First Name:EMILY
Middle Name:D
Last Name:STAPLES
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:EMILY
Other - Middle Name:R
Other - Last Name:DARR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:5113 N BEND DR
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46804-1753
Mailing Address - Country:US
Mailing Address - Phone:260-399-9020
Mailing Address - Fax:260-399-9020
Practice Address - Street 1:5113 N BEND DR
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46804-1753
Practice Address - Country:US
Practice Address - Phone:260-399-9020
Practice Address - Fax:260-399-9020
Is Sole Proprietor?:No
Enumeration Date:2018-12-03
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR010142111N00000X
OHDC-05112111N00000X
IN08003387A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor