Provider Demographics
NPI:1437469400
Name:MUSHIN PLLC
Entity Type:Organization
Organization Name:MUSHIN PLLC
Other - Org Name:GARDNER SCHOFIELD CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:FREDERICK
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:SCHOFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:262-334-8188
Mailing Address - Street 1:2100 GATEWAY CT STE 100
Mailing Address - Street 2:
Mailing Address - City:WEST BEND
Mailing Address - State:WI
Mailing Address - Zip Code:53095-8550
Mailing Address - Country:US
Mailing Address - Phone:262-334-8188
Mailing Address - Fax:262-334-8166
Practice Address - Street 1:2100 GATEWAY CT STE 100
Practice Address - Street 2:
Practice Address - City:WEST BEND
Practice Address - State:WI
Practice Address - Zip Code:53095-8550
Practice Address - Country:US
Practice Address - Phone:262-334-8188
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-08
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4575-12111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty