Provider Demographics
NPI:1215011853
Name:SCHAGEN, KURT H (DC)
Entity Type:Individual
Prefix:DR
First Name:KURT
Middle Name:H
Last Name:SCHAGEN
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 1:100 WENDELL AVE
Mailing Address - Street 2:SUITE 8
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01201-6941
Mailing Address - Country:US
Mailing Address - Phone:413-443-3577
Mailing Address - Fax:413-499-7852
Practice Address - Street 1:100 WENDELL AVE
Practice Address - Street 2:SUITE 8
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-6941
Practice Address - Country:US
Practice Address - Phone:413-443-3577
Practice Address - Fax:413-499-7852
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2013-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1389111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA043187937OtherTAX ID
MA043187937OtherTAX ID
MAY36246Medicare ID - Type Unspecified