Healthcare Provider Details

I. General information

NPI: 1316920325
Provider Name (Legal Business Name): CHAZ S SCHATZLE D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/22/2005
Last Update Date: 01/07/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1651 GALISTEO ST SUITE12
SANTA FE NM
87505-4752
US

IV. Provider business mailing address

1651 GALISTEO ST SUITE12
SANTA FE NM
87505-4752
US

V. Phone/Fax

Practice location:
  • Phone: 505-690-4057
  • Fax: 505-982-9770
Mailing address:
  • Phone: 505-690-4057
  • Fax: 505-982-9770

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1087
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: