Provider Demographics
NPI:1770999831
Name:SCHOPP CHIROPRACTIC LLC
Entity type:Organization
Organization Name:SCHOPP CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:SCHOPP
Authorized Official - Suffix:SR
Authorized Official - Credentials:DC
Authorized Official - Phone:314-843-9355
Mailing Address - Street 1:11422 GRAVOIS RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63126-3698
Mailing Address - Country:US
Mailing Address - Phone:314-843-9355
Mailing Address - Fax:
Practice Address - Street 1:11422 GRAVOIS RD
Practice Address - Street 2:SUITE 103
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63126-3698
Practice Address - Country:US
Practice Address - Phone:314-843-9355
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-09
Last Update Date:2014-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO5281261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center