Basic Information
Provider Information
NPI: 1003001694
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SCHMITT
FirstName: JULIE
MiddleName: MAE
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 485
Address2:  
City: NEW GLARUS
State: WI
PostalCode: 535740485
CountryCode: US
TelephoneNumber: 6085274960
FaxNumber: 6085274961
Practice Location
Address1: 13 SEVENTH AVENUE
Address2:  
City: NEW GLARUS
State: WI
PostalCode: 53574
CountryCode: US
TelephoneNumber: 6085274960
FaxNumber: 6085274961
Other Information
ProviderEnumerationDate: 09/07/2007
LastUpdateDate: 09/07/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
111N00000X3383-012WIY Chiropractic ProvidersChiropractor 

No ID Information.


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