Provider Demographics
NPI:1508969171
Name:SCHALL CHIROPRACTIC INC
Entity Type:Organization
Organization Name:SCHALL CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:SCHALL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:661-822-0811
Mailing Address - Street 1:PO BOX 28
Mailing Address - Street 2:20241 VALLEY BLVD SUITE D
Mailing Address - City:TEHACHAPI
Mailing Address - State:CA
Mailing Address - Zip Code:93561
Mailing Address - Country:US
Mailing Address - Phone:661-822-0811
Mailing Address - Fax:661-822-0905
Practice Address - Street 1:20241 VALLEY BLVD
Practice Address - Street 2:SUITE D
Practice Address - City:TEHACHAPI
Practice Address - State:CA
Practice Address - Zip Code:93561
Practice Address - Country:US
Practice Address - Phone:661-822-0811
Practice Address - Fax:661-822-0905
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC15374111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC0153740Medicare ID - Type Unspecified
T05736Medicare UPIN