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General NPI Number Information
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NPI Number | 1548485519
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Entity Type | Individual
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Provider Name | KENNETH LYLE SCHRAMM D.C.
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Gender | Male
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Dates
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Enumeration Date | 04/16/2007
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Last Update Date | 10/04/2010
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Provider Practice Location Address
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Address Line | 405 MAIN ST
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City | BLANCO
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State | TX
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Zip | 78606
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Country | US
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Telephone | 830-833-0889
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 145
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City | BLANCO
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State | TX
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Zip | 78606-0145
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Country | US
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Telephone | 830-833-0889
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 4511
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License Number State | TX
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