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General NPI Number Information
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NPI Number | 1396144127
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Entity Type | Organization
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Legal Business Name | INTEGRATED PAIN & JOINT CARE SC
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Dates
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Enumeration Date | 08/18/2014
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Last Update Date | 11/27/2023
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Provider Practice Location Address
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Address Line | 5261 N PORT WASHINGTON RD
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City | GLENDALE
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State | WI
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Zip | 53217-4903
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Country | US
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Telephone | 414-332-6001
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Fax |
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Provider Business Mailing Address
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Address Line | 5261 N PORT WASHINGTON RD
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City | GLENDALE
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State | WI
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Zip | 53217-4903
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Country | US
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Telephone | 414-332-6001
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. COREY SCHNEIDER
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Credential | DC
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Telephone | 414-332-6001
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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 | 4860
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 46681
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 207XX0004X
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Taxonomy Name | Orthopaedic Foot and Ankle Surgery Physician
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License Number | 868
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License Number State | WI
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Taxonomy #4
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 44735
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License Number State | WI
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