Provider Demographics
NPI:1518460237
Name:SCOTT M. SCHREIBER, DC, P.A.
Entity Type:Organization
Organization Name:SCOTT M. SCHREIBER, DC, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR, NUTRITIONIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:SCHREIBER
Authorized Official - Suffix:
Authorized Official - Credentials:DC, LN
Authorized Official - Phone:651-459-3171
Mailing Address - Street 1:8360 CITY CENTRE DR STE 120
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-3381
Mailing Address - Country:US
Mailing Address - Phone:651-459-3171
Mailing Address - Fax:651-768-5059
Practice Address - Street 1:8360 CITY CENTRE DR STE 120
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-3381
Practice Address - Country:US
Practice Address - Phone:651-459-3171
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-09
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6846111N00000X, 111NN1001X, 111NR0400X
MNN227133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Multi-Specialty
No111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Multi-Specialty
No133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Multi-Specialty