Provider Demographics
NPI:1376549493
Name:SCHUCK, ROBERT R (DC)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:R
Last Name:SCHUCK
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 1:1198 FRONT ST
Mailing Address - Street 2:
Mailing Address - City:TONGANOXIE
Mailing Address - State:KS
Mailing Address - Zip Code:66086-9707
Mailing Address - Country:US
Mailing Address - Phone:913-369-0022
Mailing Address - Fax:913-369-2836
Practice Address - Street 1:1198 FRONT ST
Practice Address - Street 2:
Practice Address - City:TONGANOXIE
Practice Address - State:KS
Practice Address - Zip Code:66086-9707
Practice Address - Country:US
Practice Address - Phone:913-369-0022
Practice Address - Fax:913-369-2836
Is Sole Proprietor?:No
Enumeration Date:2005-06-23
Last Update Date:2011-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-04654111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSU79992Medicare UPIN
KS603781Medicare ID - Type Unspecified