| Full Life Chiropractic Pllc | |
|
3212 14th Avenue South, Suite 2 Fargo ND 58103-6306 | |
| (701) 232-2662 | |
| (701) 232-9588 |
| Full Name | Full Life Chiropractic Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3212 14th Avenue South, Suite 2, Fargo, North Dakota |
| Authorized Official Name and Position | Ryan J Schroeder (OWNER OPERATOR) |
| Authorized Official Contact | 7012322662 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Full Life Chiropractic Pllc 3212 14th Avenue South, Suite 2 Fargo ND 58103-6306 Ph: (701) 232-2662 | Full Life Chiropractic Pllc 3212 14th Avenue South, Suite 2 Fargo ND 58103-6306 Ph: (701) 232-2662 |
| NPI Number | 1932426509 |
|---|---|
| Provider Enumeration Date | 04/22/2010 |
| Last Update Date | 09/06/2023 |
| Medicare PECOS PAC ID | 0547385155 |
|---|---|
| Medicare Enrollment ID | O20100918000325 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932426509 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 859 (North Dakota) | Primary |
| Provider Name | Ryan J Schroeder |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1790912954 PECOS PAC ID: 2365589850 Enrollment ID: I20100918000328 |
| Provider Name | Samantha Lauren Duffield |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1700475399 PECOS PAC ID: 6002221462 Enrollment ID: I20210216003267 |
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