Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 0104556483 | VA |
N | 111NR0400X | Rehabilitation Chiropractor | 0104556483 | VA |
NPI | 1245391226 |
---|---|
Provider Name | Dr. Jeremy Wade Schmidt |
First Address | Arlington, VA 22201-6800 |
Second Address | Annandale, VA 22033 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/12/2006 |
Last Update Date | 08/07/2007 |