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General NPI Number Information
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NPI Number | 1356540843
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Entity Type | Organization
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Legal Business Name | RICHARD SCHILO
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Dates
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Enumeration Date | 07/13/2007
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Last Update Date | 11/09/2011
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Provider Practice Location Address
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Address Line | 715A BASCOMB COMMERCIAL PKWY
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City | WOODSTOCK
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State | GA
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Zip | 30189-2466
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Country | US
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Telephone | 770-924-9400
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Fax | 770-924-3100
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Provider Business Mailing Address
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Address Line | PO BOX 2736
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City | ACWORTH
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State | GA
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Zip | 30102-0013
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Country | US
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Telephone | 770-529-3231
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Fax | 770-529-3231
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Authorized Official
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Title or Position | OWNER
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Name | DR. RICHARD L SCHILO JR.
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Credential | D.C
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Telephone | 770-529-3231
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CHIR007375
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License Number State | GA
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