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General NPI Number Information
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NPI Number | 1598065849
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Entity Type | Organization
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Legal Business Name | SCHNEIDER CHIROPRATIC OFFICE SC
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Dates
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Enumeration Date | 11/02/2010
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Last Update Date | 11/02/2010
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Provider Practice Location Address
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Address Line | 2696 NOEL DR
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City | GREEN BAY
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State | WI
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Zip | 54311-6729
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Country | US
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Telephone | 920-465-9020
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Fax | 920-465-9020
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Provider Business Mailing Address
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Address Line | 2696 NOEL DR
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City | GREEN BAY
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State | WI
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Zip | 54311-6729
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Country | US
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Telephone | 920-465-9020
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Fax | 920-465-9020
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | JILL S WILSON
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Credential |
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Telephone | 920-465-9020
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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 | 2662
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License Number State | WI
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