Provider Demographics
NPI:1699857235
Name:SCHRECK, JOHN C (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:C
Last Name:SCHRECK
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 1:306 N EVANS ST
Mailing Address - Street 2:
Mailing Address - City:TECUMSEH
Mailing Address - State:MI
Mailing Address - Zip Code:49286-1452
Mailing Address - Country:US
Mailing Address - Phone:517-423-4082
Mailing Address - Fax:517-423-4082
Practice Address - Street 1:306 N EVANS ST
Practice Address - Street 2:
Practice Address - City:TECUMSEH
Practice Address - State:MI
Practice Address - Zip Code:49286-1452
Practice Address - Country:US
Practice Address - Phone:517-423-4082
Practice Address - Fax:517-423-4082
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2011-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301002850111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3334608Medicaid
MIT33702Medicare UPIN
MI3334608Medicaid