Provider Demographics
NPI:1497885578
Name:THOMAS MARK SCHILL DC PC
Entity Type:Organization
Organization Name:THOMAS MARK SCHILL DC PC
Other - Org Name:ALPINE CHIROPRACTIC & MASSAGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:SCHILL
Authorized Official - Suffix:
Authorized Official - Credentials:DC, PC
Authorized Official - Phone:541-678-0010
Mailing Address - Street 1:PO BOX 1550
Mailing Address - Street 2:BEND
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97709-1550
Mailing Address - Country:US
Mailing Address - Phone:541-678-0010
Mailing Address - Fax:541-323-6131
Practice Address - Street 1:371 SW UPPER TERRACE DR
Practice Address - Street 2:SUITE 2
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-1560
Practice Address - Country:US
Practice Address - Phone:541-678-0010
Practice Address - Fax:541-323-6131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2016-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR273205111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500668352Medicaid
ORR173743Medicare PIN