Provider Demographics
NPI:1083940761
Name:SCHOLLMEYER, PAUL VINCENT (DC)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:VINCENT
Last Name:SCHOLLMEYER
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 1:2092 COATES ST
Mailing Address - Street 2:
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52003-7104
Mailing Address - Country:US
Mailing Address - Phone:563-542-7902
Mailing Address - Fax:
Practice Address - Street 1:2092 COATES ST
Practice Address - Street 2:
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52003-7104
Practice Address - Country:US
Practice Address - Phone:563-542-7902
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-30
Last Update Date:2009-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA007216111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor