MEDICARE: THE CRACK SHACK CHIROPRACTIC LLC

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

General Provider Information

NPI Number	:	1932064904
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE CRACK SHACK CHIROPRACTIC LLC

Provider Business Mailing Address
First Line	:	2806 MITCHELL ST
Second Line	:
City	:	GREENVILLE
State	:	TX
Zip	:	75402-8939
Country	:	US
Telephone Number	:	903-454-2225
Fax Number	:

Provider Business Practice Location Address
First Line	:	2806 MITCHELL ST
Second Line	:
City	:	GREENVILLE
State	:	TX
Zip	:	75402-8939
Country	:	US
Telephone Number	:	903-454-2225
Fax Number	:

Authorized Official
Title or Position	:	DOCTOR/OWNER
Name	:	DR. LARRY L SCHAFFER
Credential	:	DC
Telephone Number	:	817-366-4204

Provider Enumeration Date	:	12/22/2025
Last Update Date	:	12/22/2025

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Directions to “THE CRACK SHACK CHIROPRACTIC LLC ” Practice Location

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