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NPI Code Detail

MEDICARE: MARY ROXANNE SCHMIDT DC

MEDICARE:   MARY ROXANNE 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
1111N00000XChiropractorCH00002622WA

General Provider Information

NPI Number : 1689730889
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY ROXANNE SCHMIDT DC
Provider Business Mailing Address
First Line : 310 CLEVELAND AVE SE
Second Line :
City : TUMWATER
State : WA
Zip : 98501-3310
Country : US
Telephone Number : 360-943-6015
Fax Number : 360-943-2807
Provider Business Practice Location Address
First Line : 310 CLEVELAND AVE SE
Second Line :
City : TUMWATER
State : WA
Zip : 98501-3310
Country : US
Telephone Number : 360-943-6015
Fax Number : 360-943-2807
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/29/2006
Last Update Date : 07/08/2007

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Directions to “ MARY ROXANNE SCHMIDT DC” Practice Location

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