Provider Demographics
NPI:1205871332
Name:SCHAETZKE, RANDAL GENE (DC)
Entity type:Individual
Prefix:DR
First Name:RANDAL
Middle Name:GENE
Last Name:SCHAETZKE
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:PO BOX 628
Mailing Address - Street 2:
Mailing Address - City:QUECHEE
Mailing Address - State:VT
Mailing Address - Zip Code:05059-0628
Mailing Address - Country:US
Mailing Address - Phone:802-296-6030
Mailing Address - Fax:
Practice Address - Street 1:RT 4 WATERMAN PLACE
Practice Address - Street 2:WATERMAN HILL
Practice Address - City:QUECHEE
Practice Address - State:VT
Practice Address - Zip Code:05059
Practice Address - Country:US
Practice Address - Phone:802-296-6030
Practice Address - Fax:802-296-7048
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT945111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition