Provider Demographics
NPI:1568573749
Name:PHILLIP B. SCHRICKEL D.C. INC.
Entity Type:Organization
Organization Name:PHILLIP B. SCHRICKEL D.C. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILLIP
Authorized Official - Middle Name:B
Authorized Official - Last Name:SCHRICKEL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:740-545-9010
Mailing Address - Street 1:52937 COUNTY ROAD 16
Mailing Address - Street 2:
Mailing Address - City:WEST LAFAYETTE
Mailing Address - State:OH
Mailing Address - Zip Code:43845-9770
Mailing Address - Country:US
Mailing Address - Phone:740-545-9010
Mailing Address - Fax:740-545-9054
Practice Address - Street 1:52937 COUNTY ROAD 16
Practice Address - Street 2:
Practice Address - City:WEST LAFAYETTE
Practice Address - State:OH
Practice Address - Zip Code:43845-9770
Practice Address - Country:US
Practice Address - Phone:740-545-9010
Practice Address - Fax:740-545-9054
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2007-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1244111N00000X
OH3748111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0748776Medicaid
OH0748776Medicaid