Provider Demographics
NPI:1891838652
Name:SCHMITT, JOHN P (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:P
Last Name:SCHMITT
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 1:265 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CEDAR GROVE
Mailing Address - State:WI
Mailing Address - Zip Code:53013-1311
Mailing Address - Country:US
Mailing Address - Phone:920-668-8070
Mailing Address - Fax:920-668-8868
Practice Address - Street 1:265 S MAIN ST
Practice Address - Street 2:
Practice Address - City:CEDAR GROVE
Practice Address - State:WI
Practice Address - Zip Code:53013-1311
Practice Address - Country:US
Practice Address - Phone:920-668-8070
Practice Address - Fax:920-668-8868
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3202-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI70846Medicare ID - Type Unspecified