MEDICARE: PHILLIP B. SCHRICKEL D.C. INC.

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	3748	OH
2	111N00000X	Chiropractor	1244	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1568573749
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHILLIP B. SCHRICKEL D.C. INC.

Provider Business Mailing Address
First Line	:	52937 COUNTY ROAD 16
Second Line	:
City	:	WEST LAFAYETTE
State	:	OH
Zip	:	43845-9770
Country	:	US
Telephone Number	:	740-545-9010
Fax Number	:	740-545-9054

Provider Business Practice Location Address
First Line	:	52937 COUNTY ROAD 16
Second Line	:
City	:	WEST LAFAYETTE
State	:	OH
Zip	:	43845-9770
Country	:	US
Telephone Number	:	740-545-9010
Fax Number	:	740-545-9054

Authorized Official
Title or Position	:	OWNER/DOCTOR
Name	:	DR. PHILLIP B SCHRICKEL
Credential	:	D.C.
Telephone Number	:	740-545-9010

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	11/30/2007

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