MEDICARE: DR. ELIZABETH WYNN SCHRADER DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	DC0000002052	TN

General Provider Information

NPI Number	:	1710933866
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELIZABETH WYNN SCHRADER DC

Provider Business Mailing Address
First Line	:	2905 TAZEWELL PIKE
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37918-1874
Country	:	US
Telephone Number	:	865-686-1600
Fax Number	:	865-686-3380

Provider Business Practice Location Address
First Line	:	2905 TAZEWELL PIKE
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37918-1874
Country	:	US
Telephone Number	:	865-686-1600
Fax Number	:	865-686-3380

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/26/2006
Last Update Date	:	07/08/2007

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