Provider Demographics
NPI:1790869972
Name:SCHWARTZ, NEIL IRA (DC)
Entity Type:Individual
Prefix:DR
First Name:NEIL
Middle Name:IRA
Last Name:SCHWARTZ
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 1:2811 WATSON BLVD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31093-8576
Mailing Address - Country:US
Mailing Address - Phone:478-971-4110
Mailing Address - Fax:478-971-4072
Practice Address - Street 1:2811 WATSON BLVD
Practice Address - Street 2:SUITE 3
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31093-8576
Practice Address - Country:US
Practice Address - Phone:478-971-4110
Practice Address - Fax:478-971-4072
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA006059111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA35ZCFMMMedicare ID - Type Unspecified
GAU74086Medicare UPIN