Provider Demographics
NPI:1942288832
Name:SCHALLER, MICHAEL H (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:H
Last Name:SCHALLER
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:PO BOX 239
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:TN
Mailing Address - Zip Code:37349-0239
Mailing Address - Country:US
Mailing Address - Phone:931-723-2486
Mailing Address - Fax:931-723-4206
Practice Address - Street 1:806 CLOVER LN
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:TN
Practice Address - Zip Code:37355-2377
Practice Address - Country:US
Practice Address - Phone:931-723-2486
Practice Address - Fax:931-723-4206
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1122111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3677144Medicaid
TN3040217OtherBLUE CROSS BLUE SHIELD
OKU21227Medicare UPIN
TN3677144Medicaid