Provider Demographics
NPI:1841206190
Name:SCHIMP CHIROPRACTIC OFFICE LTD
Entity Type:Organization
Organization Name:SCHIMP CHIROPRACTIC OFFICE LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:SCHIMP
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:262-673-2341
Mailing Address - Street 1:PO BOX 270238
Mailing Address - Street 2:937 E SUMNER ST
Mailing Address - City:HARTFORD
Mailing Address - State:WI
Mailing Address - Zip Code:53027
Mailing Address - Country:US
Mailing Address - Phone:262-673-2341
Mailing Address - Fax:232-673-2131
Practice Address - Street 1:937 E SUMNER ST
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:WI
Practice Address - Zip Code:53027
Practice Address - Country:US
Practice Address - Phone:262-673-2341
Practice Address - Fax:262-673-2131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-31
Last Update Date:2016-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI000075326Medicare Oscar/Certification