Provider Demographics
NPI:1699968255
Name:SCHROEDER CHIROPRACTIC LLC
Entity type:Organization
Organization Name:SCHROEDER CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEMBER LLC
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:SCHROEDER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:615-451-4306
Mailing Address - Street 1:472 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:GALLATIN
Mailing Address - State:TN
Mailing Address - Zip Code:37066-3120
Mailing Address - Country:US
Mailing Address - Phone:615-451-4306
Mailing Address - Fax:615-451-2634
Practice Address - Street 1:472 W MAIN ST
Practice Address - Street 2:
Practice Address - City:GALLATIN
Practice Address - State:TN
Practice Address - Zip Code:37066-3120
Practice Address - Country:US
Practice Address - Phone:615-451-4306
Practice Address - Fax:615-451-2634
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-27
Last Update Date:2012-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3718476Medicare PIN