Provider Demographics
NPI:1881792141
Name:SCHURMANN CHIROPRACTIC & WELLNESS CENTER, LLC
Entity type:Organization
Organization Name:SCHURMANN CHIROPRACTIC & WELLNESS CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:RALF
Authorized Official - Middle Name:S
Authorized Official - Last Name:SCHURMANN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:208-267-2225
Mailing Address - Street 1:6737B CODY ST
Mailing Address - Street 2:
Mailing Address - City:BONNERS FERRY
Mailing Address - State:ID
Mailing Address - Zip Code:83805-8504
Mailing Address - Country:US
Mailing Address - Phone:208-267-2225
Mailing Address - Fax:208-267-2225
Practice Address - Street 1:6737B CODY ST
Practice Address - Street 2:
Practice Address - City:BONNERS FERRY
Practice Address - State:ID
Practice Address - Zip Code:83805-8504
Practice Address - Country:US
Practice Address - Phone:208-267-2225
Practice Address - Fax:208-267-2225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2020-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDCHIA-1719111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID000085480Medicare PIN