Healthcare Provider Details

I. General information

NPI: 1336221225
Provider Name (Legal Business Name): LORI SCHROEDER DC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/19/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 E BULLARD AVE STE 104
FRESNO CA
93710-5476
US

IV. Provider business mailing address

720 E BULLARD AVE STE 104
FRESNO CA
93710-5476
US

V. Phone/Fax

Practice location:
  • Phone: 559-439-4904
  • Fax: 559-439-5051
Mailing address:
  • Phone: 559-439-4904
  • Fax: 559-439-5051

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number16854
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: