Provider Demographics
NPI:1427634310
Name:SCHROEDER, RUTH RITA (DC)
Entity type:Individual
Prefix:DR
First Name:RUTH
Middle Name:RITA
Last Name:SCHROEDER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 CORPORATE DR
Mailing Address - Street 2:
Mailing Address - City:BEAVER DAM
Mailing Address - State:WI
Mailing Address - Zip Code:53916-3115
Mailing Address - Country:US
Mailing Address - Phone:920-887-7156
Mailing Address - Fax:920-887-7290
Practice Address - Street 1:250 CORPORATE DR
Practice Address - Street 2:
Practice Address - City:BEAVER DAM
Practice Address - State:WI
Practice Address - Zip Code:53916-3115
Practice Address - Country:US
Practice Address - Phone:920-887-7156
Practice Address - Fax:920-887-7290
Is Sole Proprietor?:No
Enumeration Date:2021-03-22
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5631-12111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor