Provider Demographics
NPI:1861503047
Name:SCHRICKEL, PHILLIP BERNARD (DC)
Entity Type:Individual
Prefix:DR
First Name:PHILLIP
Middle Name:BERNARD
Last Name:SCHRICKEL
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 1:52937 COUNTY RD. 16
Mailing Address - Street 2:
Mailing Address - City:WEST LAFAYETTE
Mailing Address - State:OH
Mailing Address - Zip Code:43845
Mailing Address - Country:US
Mailing Address - Phone:740-545-9010
Mailing Address - Fax:740-545-9054
Practice Address - Street 1:52937 COUNTY ROAD 16
Practice Address - Street 2:
Practice Address - City:WEST LAFAYETTE
Practice Address - State:OH
Practice Address - Zip Code:43845-9770
Practice Address - Country:US
Practice Address - Phone:740-545-9010
Practice Address - Fax:740-545-9054
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1244111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0748776Medicaid
OHT48546Medicare UPIN
OH0748776Medicaid