Provider Demographics
NPI:1033805734
Name:SCHMIEDECKE, ERIC (LAC)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:SCHMIEDECKE
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2159 HENDERSONVILLE RD STE 50
Mailing Address - Street 2:
Mailing Address - City:ARDEN
Mailing Address - State:NC
Mailing Address - Zip Code:28704-9721
Mailing Address - Country:US
Mailing Address - Phone:828-333-1413
Mailing Address - Fax:
Practice Address - Street 1:2159 HENDERSONVILLE RD STE 50
Practice Address - Street 2:
Practice Address - City:ARDEN
Practice Address - State:NC
Practice Address - Zip Code:28704-9721
Practice Address - Country:US
Practice Address - Phone:828-333-1413
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-14
Last Update Date:2023-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC955171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist