MEDICARE: SCHMIDT CHIROPRACTIC, P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	1772	NE

General Provider Information

NPI Number	:	1073947909
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SCHMIDT CHIROPRACTIC, P.C.

Provider Business Mailing Address
First Line	:	3714 S 132ND ST
Second Line	:	SUITE #6
City	:	OMAHA
State	:	NE
Zip	:	68144-3608
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3714 S 132ND ST
Second Line	:	SUITE #6
City	:	OMAHA
State	:	NE
Zip	:	68144-3608
Country	:	US
Telephone Number	:	402-677-7410
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. KELLY SCHMIDT
Credential	:	D.C.
Telephone Number	:	402-677-7410

Provider Enumeration Date	:	08/27/2013
Last Update Date	:	08/27/2013

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