Basic Information
Provider Information
NPI: 1922464205
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SCHAEFBAUER
FirstName: NATHAN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: D.C.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 705 PLEASANT AVE S
Address2:  
City: PARK RAPIDS
State: MN
PostalCode: 564701440
CountryCode: US
TelephoneNumber: 2187322800
FaxNumber:  
Practice Location
Address1: 705 PLEASANT AVE S
Address2:  
City: PARK RAPIDS
State: MN
PostalCode: 564701440
CountryCode: US
TelephoneNumber: 2187322800
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/03/2016
LastUpdateDate: 07/10/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/10/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
111N00000X6181MNY Chiropractic ProvidersChiropractor 

No ID Information.


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