Provider Demographics
NPI:1235185216
Name:SANDY LAKE CHIROPRACTIC
Entity Type:Organization
Organization Name:SANDY LAKE CHIROPRACTIC
Other - Org Name:CORE CHIROPRACTIC AND PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:SCHNAPPAUF
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:972-393-8067
Mailing Address - Street 1:546 E SANDY LAKE RD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019-5786
Mailing Address - Country:US
Mailing Address - Phone:972-393-8067
Mailing Address - Fax:972-393-6959
Practice Address - Street 1:546 E SANDY LAKE RD
Practice Address - Street 2:SUITE 110
Practice Address - City:COPPELL
Practice Address - State:TX
Practice Address - Zip Code:75019-5786
Practice Address - Country:US
Practice Address - Phone:972-393-8067
Practice Address - Fax:972-393-6959
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-25
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6769111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty