Provider Demographics
NPI:1245391226
Name:SCHMIDT, JEREMY WADE (DC)
Entity Type:Individual
Prefix:DR
First Name:JEREMY
Middle Name:WADE
Last Name:SCHMIDT
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 1:1201 N GARFIELD ST
Mailing Address - Street 2:601
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22201-6800
Mailing Address - Country:US
Mailing Address - Phone:703-888-0880
Mailing Address - Fax:703-333-5023
Practice Address - Street 1:6940-A BRADDOCK RD.
Practice Address - Street 2:
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22033
Practice Address - Country:US
Practice Address - Phone:703-333-5022
Practice Address - Fax:703-333-5023
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104556483111N00000X, 111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered111N00000XChiropractic ProvidersChiropractor
Not Answered111NR0400XChiropractic ProvidersChiropractorRehabilitation