Healthcare Provider Details

I. General information

NPI: 1366534455
Provider Name (Legal Business Name): RUSSELL S SCHIERLING DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: TRACY L TRUDE

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 09/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1219 HWY 17 SOUTH
MOUNTAIN VIEW MO
65548
US

IV. Provider business mailing address

1219 SOUTH STATE ROUTE HWY 17
MOUNTAIN VIEW MO
65548
US

V. Phone/Fax

Practice location:
  • Phone: 417-934-6337
  • Fax: 417-934-6277
Mailing address:
  • Phone: 417-934-6337
  • Fax: 417-934-6277

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCE006013
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: