Provider Demographics
NPI:1952502122
Name:SCHROCK CHIROPRACTIC ACUPUNCTURE PC
Entity Type:Organization
Organization Name:SCHROCK CHIROPRACTIC ACUPUNCTURE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:L
Authorized Official - Last Name:SCHROCK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:308-236-6499
Mailing Address - Street 1:218 W 39TH ST
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68845-2802
Mailing Address - Country:US
Mailing Address - Phone:308-236-6499
Mailing Address - Fax:308-236-5050
Practice Address - Street 1:218 WEST 39TH STREET
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68845
Practice Address - Country:US
Practice Address - Phone:308-236-6499
Practice Address - Fax:308-236-2050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-29
Last Update Date:2008-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1187111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty