Provider Demographics
NPI:1992718365
Name:SCHLADE, ROGER EDWIN (DC)
Entity type:Individual
Prefix:DR
First Name:ROGER
Middle Name:EDWIN
Last Name:SCHLADE
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 1:3141 SCOTT RD
Mailing Address - Street 2:
Mailing Address - City:SWANTON
Mailing Address - State:OH
Mailing Address - Zip Code:43558-9419
Mailing Address - Country:US
Mailing Address - Phone:419-825-3141
Mailing Address - Fax:
Practice Address - Street 1:113 W LYNN ST
Practice Address - Street 2:
Practice Address - City:EDGERTON
Practice Address - State:OH
Practice Address - Zip Code:43517-9597
Practice Address - Country:US
Practice Address - Phone:419-298-1700
Practice Address - Fax:419-298-1900
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH167111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0385403Medicare UPIN