Provider Demographics
NPI:1356540843
Name:RICHARD SCHILO
Entity type:Organization
Organization Name:RICHARD SCHILO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:L
Authorized Official - Last Name:SCHILO
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:770-529-3231
Mailing Address - Street 1:PO BOX 2736
Mailing Address - Street 2:
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30102-0013
Mailing Address - Country:US
Mailing Address - Phone:770-529-3231
Mailing Address - Fax:770-529-3231
Practice Address - Street 1:715A BASCOMB COMMERCIAL PKWY
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30189-2466
Practice Address - Country:US
Practice Address - Phone:770-924-9400
Practice Address - Fax:770-924-3100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-13
Last Update Date:2011-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR007375111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty