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Organization
SPORTS & FAMILY CHIROPRACTIC LTD
Active
Organization
SPORTS & FAMILY CHIROPRACTIC LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEITH HEIM SCHALLER (OWNER CHIROPRACTOR)
(802) 244-1365
Entity
Organization
Contact information
Practice address
65 S MAIN ST, SUITE 2, WATERBURY, VT 05676-1550
(802) 244-1365
(802) 244-0840
Mailing address
65 S MAIN ST, SUITE 2, WATERBURY, VT 05676-1550
(802) 244-1365
(802) 244-0840
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
0060001123
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0VN3711
—
VT
01
—
67513
CIGNA
VT
01
—
68628
BLUE CROSS BLUE SHIELD
VT
Enumeration date
11/02/2005
Last updated
08/22/2020
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