Provider Demographics
NPI:1497754402
Name:BRYAN SCHUETZ, DC, INC.
Entity Type:Organization
Organization Name:BRYAN SCHUETZ, DC, INC.
Other - Org Name:CAPITAL CITY CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER - PRES OF CORP
Authorized Official - Prefix:
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:R
Authorized Official - Last Name:SCHUETZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:614-436-3870
Mailing Address - Street 1:5577 N HIGH ST
Mailing Address - Street 2:
Mailing Address - City:WORTHINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43085-3914
Mailing Address - Country:US
Mailing Address - Phone:614-436-3870
Mailing Address - Fax:614-436-0953
Practice Address - Street 1:5577 N HIGH ST
Practice Address - Street 2:
Practice Address - City:WORTHINGTON
Practice Address - State:OH
Practice Address - Zip Code:43085-3914
Practice Address - Country:US
Practice Address - Phone:614-436-3870
Practice Address - Fax:614-436-0953
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0239512Medicaid
U55134Medicare UPIN
OH0239512Medicaid