Provider Demographics
NPI:1902837438
Name:SCHLAFFER, KATHERINE MADELINE (DC)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:MADELINE
Last Name:SCHLAFFER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1255 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:AGAWAM
Mailing Address - State:MA
Mailing Address - Zip Code:01001-2536
Mailing Address - Country:US
Mailing Address - Phone:413-789-2143
Mailing Address - Fax:413-789-7136
Practice Address - Street 1:192 SHOEMAKER LN
Practice Address - Street 2:
Practice Address - City:AGAWAM
Practice Address - State:MA
Practice Address - Zip Code:01001-3616
Practice Address - Country:US
Practice Address - Phone:413-789-1369
Practice Address - Fax:413-789-7136
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2008-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA620111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1608924Medicaid
MA042739973OtherTAX IDENTIFICATION NUMBER
MA042739973OtherTAX IDENTIFICATION NUMBER