Provider Demographics
NPI:1477757490
Name:SCHMIDT CHIROPRACTIC CENTER P. A.
Entity Type:Organization
Organization Name:SCHMIDT CHIROPRACTIC CENTER P. A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:SCHMIDT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:952-467-2505
Mailing Address - Street 1:320 HILL STREET
Mailing Address - Street 2:PO BOX 215
Mailing Address - City:NORWOOD YOUNG AMERICA
Mailing Address - State:MN
Mailing Address - Zip Code:55368
Mailing Address - Country:US
Mailing Address - Phone:952-467-2505
Mailing Address - Fax:952-467-9104
Practice Address - Street 1:320 HILL STREET
Practice Address - Street 2:
Practice Address - City:NORWOOD YOUNG AMERICA
Practice Address - State:MN
Practice Address - Zip Code:55368
Practice Address - Country:US
Practice Address - Phone:952-467-2505
Practice Address - Fax:952-467-9104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-13
Last Update Date:2013-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3968111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN0609005-00Medicaid
MN0609005-00Medicaid
MNU83608Medicare UPIN