Provider Demographics
NPI:1235710443
Name:SCHEIDECKER, TRENT (DC)
Entity Type:Individual
Prefix:
First Name:TRENT
Middle Name:
Last Name:SCHEIDECKER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:TRENT
Other - Middle Name:MICHAEL
Other - Last Name:SCHEIDECKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:650 COMMERCE DR. STE. 155
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125
Mailing Address - Country:US
Mailing Address - Phone:877-442-4476
Mailing Address - Fax:
Practice Address - Street 1:650 COMMERCE DR. STE. 155
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125
Practice Address - Country:US
Practice Address - Phone:877-442-4476
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-19
Last Update Date:2021-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5377111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor