MEDICARE: DR. KRISTAL SCHMIDT DC

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	674	WY

General Provider Information

NPI Number	:	1619971405
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KRISTAL SCHMIDT DC

Provider Business Mailing Address
First Line	:	201 W LAKEWAY RD
Second Line	:	STE 200
City	:	GILLETTE
State	:	WY
Zip	:	82718-6341
Country	:	US
Telephone Number	:	307-682-7885
Fax Number	:	307-682-2153

Provider Business Practice Location Address
First Line	:	201 W LAKEWAY RD
Second Line	:	STE 200
City	:	GILLETTE
State	:	WY
Zip	:	82718-6341
Country	:	US
Telephone Number	:	307-682-7885
Fax Number	:	307-682-2153

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2005
Last Update Date	:	09/07/2017

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Directions to “ DR. KRISTAL SCHMIDT DC” Practice Location

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