Healthcare Provider Details

I. General information

NPI: 1982055356
Provider Name (Legal Business Name): DAVID J SCHIMP DC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2016
Last Update Date: 06/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

937 E SUMNER ST
HARTFORD WI
53027-1605
US

IV. Provider business mailing address

937 E SUMNER ST
HARTFORD WI
53027-1605
US

V. Phone/Fax

Practice location:
  • Phone: 262-673-2341
  • Fax:
Mailing address:
  • Phone: 262-673-2341
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN0400X
TaxonomyNeurology Chiropractor
License Number2806
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number2806-12
License Number StateWI

VIII. Authorized Official

Name: DR. DAVID J SCHIMP
Title or Position: PRESIDENT
Credential: D.C.
Phone: 262-673-2341