Provider Demographics
NPI:1235354077
Name:SCHMITT, JERRY A (DC)
Entity Type:Individual
Prefix:DR
First Name:JERRY
Middle Name:A
Last Name:SCHMITT
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 1:24 LEWIS ST
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06103-2501
Mailing Address - Country:US
Mailing Address - Phone:860-278-9141
Mailing Address - Fax:860-525-4013
Practice Address - Street 1:24 LEWIS ST
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06103-2501
Practice Address - Country:US
Practice Address - Phone:860-278-9141
Practice Address - Fax:860-525-4013
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2013-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009773111N00000X
CT001654111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor