Provider Demographics
NPI:1205901089
Name:SCHMITT, PETER JAMES (DC)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:JAMES
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:PO BOX 485
Mailing Address - Street 2:
Mailing Address - City:NEW GLARUS
Mailing Address - State:WI
Mailing Address - Zip Code:53574-0485
Mailing Address - Country:US
Mailing Address - Phone:608-527-4960
Mailing Address - Fax:608-527-4961
Practice Address - Street 1:13 7TH AVENUE
Practice Address - Street 2:
Practice Address - City:NEW GLARUS
Practice Address - State:WI
Practice Address - Zip Code:53574
Practice Address - Country:US
Practice Address - Phone:608-527-4960
Practice Address - Fax:608-527-4961
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4063-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38960200Medicaid
WI38960200Medicaid