Provider Demographics
NPI:1407803364
Name:S & S CHIROPRACTIC CLINIC INC.
Entity Type:Organization
Organization Name:S & S CHIROPRACTIC CLINIC INC.
Other - Org Name:SCHNEIDER FAMILY CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:BRIAN
Authorized Official - Last Name:SCHNEIDER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:616-949-9010
Mailing Address - Street 1:4835 CASCADE RD SE
Mailing Address - Street 2:SUITE #2
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546-3764
Mailing Address - Country:US
Mailing Address - Phone:616-949-9010
Mailing Address - Fax:616-949-9012
Practice Address - Street 1:4835 CASCADE RD SE
Practice Address - Street 2:SUITE #2
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-3764
Practice Address - Country:US
Practice Address - Phone:616-949-9010
Practice Address - Fax:616-949-9012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIJS008108111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4412496Medicaid
MI4412496Medicaid