Provider Demographics
NPI:1134461791
Name:SCHECTER, JOHN C
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:C
Last Name:SCHECTER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 N COMMERCIAL ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:TRINIDAD
Mailing Address - State:CO
Mailing Address - Zip Code:81082-2654
Mailing Address - Country:US
Mailing Address - Phone:719-846-7727
Mailing Address - Fax:
Practice Address - Street 1:210 N COMMERCIAL ST
Practice Address - Street 2:SUITE B
Practice Address - City:TRINIDAD
Practice Address - State:CO
Practice Address - Zip Code:81082-2654
Practice Address - Country:US
Practice Address - Phone:719-846-7727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-21
Last Update Date:2013-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO215237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist