Provider Demographics
NPI:1528382793
Name:SCHUMANN CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:SCHUMANN CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEVIN
Authorized Official - Middle Name:D
Authorized Official - Last Name:SCHUMANN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:920-478-2020
Mailing Address - Street 1:143 N MONROE ST
Mailing Address - Street 2:
Mailing Address - City:WATERLOO
Mailing Address - State:WI
Mailing Address - Zip Code:53594-1124
Mailing Address - Country:US
Mailing Address - Phone:920-478-2020
Mailing Address - Fax:
Practice Address - Street 1:143 N MONROE ST
Practice Address - Street 2:
Practice Address - City:WATERLOO
Practice Address - State:WI
Practice Address - Zip Code:53594-1124
Practice Address - Country:US
Practice Address - Phone:920-478-2020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-17
Last Update Date:2013-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4585-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1447572243Medicaid