Healthcare Provider Details

I. General information

NPI: 1578714226
Provider Name (Legal Business Name): SCHROEDER CHIROPRACTIC, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2008
Last Update Date: 07/15/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5801 CEDAR LAKE RD S
ST LOUIS PARK MN
55416-1481
US

IV. Provider business mailing address

5801 CEDAR LAKE RD S
ST LOUIS PARK MN
55416-1481
US

V. Phone/Fax

Practice location:
  • Phone: 952-542-3908
  • Fax:
Mailing address:
  • Phone: 952-542-3908
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: SHARON RAE SCHROEDER
Title or Position: OWNER
Credential: D.C.
Phone: 952-542-3908