Provider Demographics
NPI:1982055356
Name:DAVID J SCHIMP DC LLC
Entity type:Organization
Organization Name:DAVID J SCHIMP DC LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:J
Authorized Official - Last Name:SCHIMP
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:262-673-2341
Mailing Address - Street 1:937 E SUMNER ST
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:WI
Mailing Address - Zip Code:53027-1605
Mailing Address - Country:US
Mailing Address - Phone:262-673-2341
Mailing Address - Fax:
Practice Address - Street 1:937 E SUMNER ST
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:WI
Practice Address - Zip Code:53027-1605
Practice Address - Country:US
Practice Address - Phone:262-673-2341
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-28
Last Update Date:2016-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2806111NN0400X
WI2806-12111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN0400XChiropractic ProvidersChiropractorNeurologyGroup - Single Specialty
No111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI75326Medicare UPIN