Provider Demographics
NPI:1316194376
Name:SCHADLER, EMILY SUE (DC)
Entity Type:Individual
Prefix:DR
First Name:EMILY
Middle Name:SUE
Last Name:SCHADLER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3760 SIXES RD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:CANTON
Mailing Address - State:GA
Mailing Address - Zip Code:30114-8192
Mailing Address - Country:US
Mailing Address - Phone:770-704-4580
Mailing Address - Fax:
Practice Address - Street 1:3760 SIXES RD
Practice Address - Street 2:SUITE 120
Practice Address - City:CANTON
Practice Address - State:GA
Practice Address - Zip Code:30114-8192
Practice Address - Country:US
Practice Address - Phone:770-704-4580
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-21
Last Update Date:2008-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIRO005505111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA35ZCHFWMedicare PIN