Healthcare Provider Details

I. General information

NPI: 1205901089
Provider Name (Legal Business Name): PETER JAMES SCHMITT D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/21/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13 7TH AVENUE
NEW GLARUS WI
53574
US

IV. Provider business mailing address

PO BOX 485
NEW GLARUS WI
53574-0485
US

V. Phone/Fax

Practice location:
  • Phone: 608-527-4960
  • Fax: 608-527-4961
Mailing address:
  • Phone: 608-527-4960
  • Fax: 608-527-4961

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4063-012
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: