Provider Demographics
NPI:1235120940
Name:SCHEMENAUER, JEFFREY J (DC)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:J
Last Name:SCHEMENAUER
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 1:2303 SCHNEIDER AVE SE
Mailing Address - Street 2:SUITE 150
Mailing Address - City:MENOMONIE
Mailing Address - State:WI
Mailing Address - Zip Code:54751-7005
Mailing Address - Country:US
Mailing Address - Phone:715-233-1867
Mailing Address - Fax:715-233-1868
Practice Address - Street 1:2303 SCHNEIDER AVE SE
Practice Address - Street 2:SUITE 150
Practice Address - City:MENOMONIE
Practice Address - State:WI
Practice Address - Zip Code:54751-7005
Practice Address - Country:US
Practice Address - Phone:715-233-1867
Practice Address - Fax:715-233-1868
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2012-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3634111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38921700Medicaid
WI38921700Medicaid
U78150Medicare UPIN