Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | CR2205 | ME |
NPI | 1003214602 |
---|---|
Provider Name | Dr. Diane Schroeder |
First Address | Eliot, ME 03903-1952 |
Second Address | Eliot, ME 03903 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/12/2014 |
Last Update Date | 07/06/2018 |