Healthcare Provider Details

I. General information

NPI: 1902873920
Provider Name (Legal Business Name): THOMAS J SCHREDER D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/08/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1069 NEW HOLLAND AVE
LANCASTER PA
17601-5605
US

IV. Provider business mailing address

1069 NEW HOLLAND AVE
LANCASTER PA
17601-5605
US

V. Phone/Fax

Practice location:
  • Phone: 717-291-1568
  • Fax:
Mailing address:
  • Phone: 717-291-1568
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number002475-L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: