MEDICARE: SCHULLER CHIROPRACTIC PLLC

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

General Provider Information

NPI Number	:	1568153302
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SCHULLER CHIROPRACTIC PLLC

Provider Business Mailing Address
First Line	:	2093 E 9400 S
Second Line	:
City	:	SANDY
State	:	UT
Zip	:	84093-3128
Country	:	US
Telephone Number	:	801-872-7875
Fax Number	:

Provider Business Practice Location Address
First Line	:	2093 E 9400 S
Second Line	:
City	:	SANDY
State	:	UT
Zip	:	84093-3128
Country	:	US
Telephone Number	:	801-872-7875
Fax Number	:

Authorized Official
Title or Position	:	OWNER/CHIROPRACTOR
Name	:	DR. ANTHONY SCHULLER
Credential	:	DC
Telephone Number	:	801-872-7875

Provider Enumeration Date	:	05/15/2023
Last Update Date	:	05/15/2023

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