Provider Demographics
NPI:1669879037
Name:SCHMIDT, CHAD CHRISTOPHER (DC)
Entity type:Individual
Prefix:DR
First Name:CHAD
Middle Name:CHRISTOPHER
Last Name:SCHMIDT
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 1:1115 HAVANA ST
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15904-1014
Mailing Address - Country:US
Mailing Address - Phone:215-518-1043
Mailing Address - Fax:
Practice Address - Street 1:1115 HAVANA ST
Practice Address - Street 2:
Practice Address - City:JOHNSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15904-1014
Practice Address - Country:US
Practice Address - Phone:215-518-1043
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-01
Last Update Date:2014-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC010959111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor