Provider Demographics
NPI:1568523074
Name:COMPLETE CHIROPRACTIC, P.C.
Entity Type:Organization
Organization Name:COMPLETE CHIROPRACTIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:E
Authorized Official - Last Name:SCHREIBER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:301-631-5602
Mailing Address - Street 1:1446 W PATRICK ST
Mailing Address - Street 2:UNIT 14
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-3200
Mailing Address - Country:US
Mailing Address - Phone:301-631-5602
Mailing Address - Fax:301-631-1589
Practice Address - Street 1:1446 W PATRICK ST
Practice Address - Street 2:UNIT 14
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-3200
Practice Address - Country:US
Practice Address - Phone:301-631-5602
Practice Address - Fax:301-631-1589
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2011-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS01722111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
172QMedicare PIN