MEDICARE: SANDY LAKE CHIROPRACTIC

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	6769	TX

General Provider Information

NPI Number	:	1235185216
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SANDY LAKE CHIROPRACTIC

Provider Business Mailing Address
First Line	:	546 E SANDY LAKE RD
Second Line	:	SUITE 110
City	:	COPPELL
State	:	TX
Zip	:	75019-5786
Country	:	US
Telephone Number	:	972-393-8067
Fax Number	:	972-393-6959

Provider Business Practice Location Address
First Line	:	546 E SANDY LAKE RD
Second Line	:	SUITE 110
City	:	COPPELL
State	:	TX
Zip	:	75019-5786
Country	:	US
Telephone Number	:	972-393-8067
Fax Number	:	972-393-6959

Authorized Official
Title or Position	:	OWNER/DIRECTOR
Name	:	DR. MICHAEL J SCHNAPPAUF
Credential	:	D.C.
Telephone Number	:	972-393-8067

Provider Enumeration Date	:	05/25/2006
Last Update Date	:	07/16/2008

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Directions to “SANDY LAKE CHIROPRACTIC ” Practice Location

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