Provider Demographics
NPI:1992993703
Name:SCHOENHERR CHIROPRACTIC INC.
Entity type:Organization
Organization Name:SCHOENHERR CHIROPRACTIC INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:G
Authorized Official - Last Name:SCHOENHERR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:636-477-8885
Mailing Address - Street 1:1365 TRIAD CENTER DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:SAINT PETERS
Mailing Address - State:MO
Mailing Address - Zip Code:63376-7352
Mailing Address - Country:US
Mailing Address - Phone:636-477-8885
Mailing Address - Fax:636-441-2670
Practice Address - Street 1:1365 TRIAD CENTER DR
Practice Address - Street 2:SUITE B
Practice Address - City:SAINT PETERS
Practice Address - State:MO
Practice Address - Zip Code:63376-7352
Practice Address - Country:US
Practice Address - Phone:636-477-8885
Practice Address - Fax:636-441-2670
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-05
Last Update Date:2013-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO759705908Medicaid
MO759705908Medicaid
MO990001698Medicare PIN