Provider Demographics
NPI:1770582629
Name:SCHUETZ, BRYAN (DC)
Entity type:Individual
Prefix:
First Name:BRYAN
Middle Name:
Last Name:SCHUETZ
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 1:5577 N HIGH ST
Mailing Address - Street 2:
Mailing Address - City:WORTHINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43085-3914
Mailing Address - Country:US
Mailing Address - Phone:614-436-3870
Mailing Address - Fax:614-436-0953
Practice Address - Street 1:5577 N HIGH ST
Practice Address - Street 2:
Practice Address - City:WORTHINGTON
Practice Address - State:OH
Practice Address - Zip Code:43085-3914
Practice Address - Country:US
Practice Address - Phone:614-436-3870
Practice Address - Fax:614-436-0953
Is Sole Proprietor?:No
Enumeration Date:2005-07-21
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2204111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0130996Medicaid
55134Medicare UPIN
OH9282611Medicare PIN