Provider Demographics
NPI:1396970372
Name:SCHNARR, TIFFANY MARIE (DC)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:MARIE
Last Name:SCHNARR
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:TIFFANY
Other - Middle Name:SCHNARR
Other - Last Name:SCHAFER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:1107 S STEWART AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65804-0324
Mailing Address - Country:US
Mailing Address - Phone:417-619-3635
Mailing Address - Fax:
Practice Address - Street 1:1107 S STEWART AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65804-0324
Practice Address - Country:US
Practice Address - Phone:417-619-3635
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-20
Last Update Date:2016-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2009000027111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO149158010Medicare UPIN