Healthcare Provider Details

I. General information

NPI: 1689140980
Provider Name (Legal Business Name): BRIANNE KERRY SCHROEDER DC; MSACN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/15/2018
Last Update Date: 11/12/2021
Certification Date: 11/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4841 WILLIAMS DR STE 110C
GEORGETOWN TX
78633-2006
US

IV. Provider business mailing address

4841 WILLIAMS DR STE 110C
GEORGETOWN TX
78633-2006
US

V. Phone/Fax

Practice location:
  • Phone: 518-929-0707
  • Fax:
Mailing address:
  • Phone: 518-929-0707
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number13913
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number12870
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: