Provider Demographics
NPI:1699982850
Name:SCHROERING, MARK E (DC)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:E
Last Name:SCHROERING
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 1:685 NW 5TH STREET
Mailing Address - Street 2:STE B
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97330
Mailing Address - Country:US
Mailing Address - Phone:541-758-9096
Mailing Address - Fax:
Practice Address - Street 1:685 NW 5TH STREET
Practice Address - Street 2:STE B
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97330
Practice Address - Country:US
Practice Address - Phone:541-758-9096
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR273176111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U79385Medicare UPIN
108423Medicare ID - Type Unspecified