Provider Demographics
NPI:1396752705
Name:SCHULD, JOHN TERRY JR (DC)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:TERRY
Last Name:SCHULD
Suffix:JR
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 1:6609 FRANKFORD AVENUE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19135-2508
Mailing Address - Country:US
Mailing Address - Phone:215-624-0344
Mailing Address - Fax:215-624-3887
Practice Address - Street 1:6609 FRANKFORD AVENUE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19135-2508
Practice Address - Country:US
Practice Address - Phone:215-624-0344
Practice Address - Fax:215-624-3887
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC002408L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0061143000OtherPERSONAL CHOICE
PA71035439865OtherBLUE SHIELD
PA0061143000OtherPERSONAL CHOICE