Provider Demographics
NPI:1720247679
Name:SCHMITZ CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:SCHMITZ CHIROPRACTIC, LLC
Other - Org Name:SCHMITZ CHIROPRACTIC AND MEDICAL SPA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/D.C.
Authorized Official - Prefix:DR
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:GERALD
Authorized Official - Last Name:SCHMITZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:636-464-8828
Mailing Address - Street 1:1502 PREHISTORIC HILL DR
Mailing Address - Street 2:
Mailing Address - City:IMPERIAL
Mailing Address - State:MO
Mailing Address - Zip Code:63052-2288
Mailing Address - Country:US
Mailing Address - Phone:636-464-8828
Mailing Address - Fax:636-464-8838
Practice Address - Street 1:1502 PREHISTORIC HILL DR
Practice Address - Street 2:
Practice Address - City:IMPERIAL
Practice Address - State:MO
Practice Address - Zip Code:63052-2288
Practice Address - Country:US
Practice Address - Phone:636-464-8828
Practice Address - Fax:636-464-8838
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-05
Last Update Date:2008-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty