Provider Demographics
NPI:1710275615
Name:SCHOMP, BROOKE (DC, BS)
Entity Type:Individual
Prefix:DR
First Name:BROOKE
Middle Name:
Last Name:SCHOMP
Suffix:
Gender:F
Credentials:DC, BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 W LAWLER AVE
Mailing Address - Street 2:
Mailing Address - City:CHAMBERLAIN
Mailing Address - State:SD
Mailing Address - Zip Code:57325-1517
Mailing Address - Country:US
Mailing Address - Phone:605-234-2225
Mailing Address - Fax:605-234-2224
Practice Address - Street 1:113 W LAWLER AVE
Practice Address - Street 2:
Practice Address - City:CHAMBERLAIN
Practice Address - State:SD
Practice Address - Zip Code:57325-1517
Practice Address - Country:US
Practice Address - Phone:605-234-2225
Practice Address - Fax:605-234-2224
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-13
Last Update Date:2011-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD1196111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SDS105307Medicare PIN