Healthcare Provider Details

I. General information

NPI: 1174545750
Provider Name (Legal Business Name): ERIK R SCHMIDT DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2006
Last Update Date: 07/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1186 CHURCH STREET
MOSCOW PA
18444
US

IV. Provider business mailing address

1186 CHURCH STREET
MOSCOW PA
18444
US

V. Phone/Fax

Practice location:
  • Phone: 570-842-5131
  • Fax: 570-842-5126
Mailing address:
  • Phone: 570-842-5131
  • Fax: 570-842-5126

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC6782L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberAJ006782L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: