Provider Demographics
NPI:1003237140
Name:NICHOLAS M SCHOTZKO
Entity Type:Organization
Organization Name:NICHOLAS M SCHOTZKO
Other - Org Name:PALISADES CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:SCHOTZKO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:605-594-2011
Mailing Address - Street 1:632 N MAIN AVE
Mailing Address - Street 2:
Mailing Address - City:GARRETSON
Mailing Address - State:SD
Mailing Address - Zip Code:57030-8801
Mailing Address - Country:US
Mailing Address - Phone:605-594-2011
Mailing Address - Fax:605-594-2011
Practice Address - Street 1:632 N MAIN AVE
Practice Address - Street 2:
Practice Address - City:GARRETSON
Practice Address - State:SD
Practice Address - Zip Code:57030-8801
Practice Address - Country:US
Practice Address - Phone:605-594-2011
Practice Address - Fax:605-594-2011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-16
Last Update Date:2013-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD1161111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty