Provider Demographics
NPI:1447069992
Name:SCHROEDER, MITCHELL STEVEN (DC)
Entity type:Individual
Prefix:
First Name:MITCHELL
Middle Name:STEVEN
Last Name:SCHROEDER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 LAKE BLVD S
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:MN
Mailing Address - Zip Code:55313-1448
Mailing Address - Country:US
Mailing Address - Phone:763-682-1849
Mailing Address - Fax:
Practice Address - Street 1:130 LAKE BLVD S
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:MN
Practice Address - Zip Code:55313-1448
Practice Address - Country:US
Practice Address - Phone:763-682-1849
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-30
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN7293111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor