Provider Demographics
NPI:1063430494
Name:SCHROER, JOHN ROBERT (DC)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:ROBERT
Last Name:SCHROER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:182 S WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:CONSTANTINE
Mailing Address - State:MI
Mailing Address - Zip Code:49042
Mailing Address - Country:US
Mailing Address - Phone:269-435-2785
Mailing Address - Fax:269-435-2785
Practice Address - Street 1:182 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:CONSTANTINE
Practice Address - State:MI
Practice Address - Zip Code:49042
Practice Address - Country:US
Practice Address - Phone:269-435-2785
Practice Address - Fax:269-435-2785
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301004387111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIP56624OtherBLUE CARE NETWORK
0G55002Medicare ID - Type Unspecified