Healthcare Provider Details

I. General information

NPI: 1326126434
Provider Name (Legal Business Name): GOODYEAR CHIROPRACTIC HEALTH CENTER. S.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5261 N PORT WASHINGTON RD
GLENDALE WI
53217-4903
US

IV. Provider business mailing address

5261 N PORT WASHINGTON RD
GLENDALE WI
53217-4903
US

V. Phone/Fax

Practice location:
  • Phone: 414-332-6001
  • Fax: 414-332-3712
Mailing address:
  • Phone: 414-332-6001
  • Fax: 414-332-3712

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number3825-012
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number3825-012
License Number StateWI
# 3
Primary TaxonomyN
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. COREY JAMES SCHNEIDER
Title or Position: OWNER
Credential: D.C.
Phone: 414-332-6001