Provider Demographics
NPI:1639237480
Name:SCHNOBRICH, MARC STEVEN (DC)
Entity Type:Individual
Prefix:DR
First Name:MARC
Middle Name:STEVEN
Last Name:SCHNOBRICH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 752
Mailing Address - Street 2:5779 HWY 21
Mailing Address - City:RINCON
Mailing Address - State:GA
Mailing Address - Zip Code:31326
Mailing Address - Country:US
Mailing Address - Phone:912-826-4490
Mailing Address - Fax:912-826-2844
Practice Address - Street 1:5779 HWY 21 SOUTH
Practice Address - Street 2:
Practice Address - City:RINCON
Practice Address - State:GA
Practice Address - Zip Code:31326
Practice Address - Country:US
Practice Address - Phone:912-826-4490
Practice Address - Fax:912-826-2844
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2008-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA5633111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00807067AMedicaid
35ZCDWCMedicare ID - Type Unspecified
GA511I350112Medicare PIN
GAU66806Medicare UPIN