Provider Demographics
NPI:1194829481
Name:SCHNAPPAUF, KEITH G (DC)
Entity type:Individual
Prefix:
First Name:KEITH
Middle Name:G
Last Name:SCHNAPPAUF
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 1:345 UNION HILL RD
Mailing Address - Street 2:COVERED BRIDGE CHIROPRACTIC CENTER
Mailing Address - City:MANALAPAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726-1875
Mailing Address - Country:US
Mailing Address - Phone:732-536-8700
Mailing Address - Fax:732-536-0448
Practice Address - Street 1:345 UNION HILL RD
Practice Address - Street 2:COVERED BRIDGE CHIROPRACTIC CENTER
Practice Address - City:MANALAPAN
Practice Address - State:NJ
Practice Address - Zip Code:07726-1875
Practice Address - Country:US
Practice Address - Phone:732-536-8700
Practice Address - Fax:732-536-0448
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-08
Last Update Date:2007-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ03590111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ618211Medicare ID - Type UnspecifiedMEDICARE ID