Provider Demographics
NPI:1548692957
Name:SCHEINGRABER, JOAN (LAC)
Entity type:Individual
Prefix:
First Name:JOAN
Middle Name:
Last Name:SCHEINGRABER
Suffix:
Gender:F
Credentials:LAC
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 4682
Mailing Address - Street 2:
Mailing Address - City:KETCHUM
Mailing Address - State:ID
Mailing Address - Zip Code:83340-4682
Mailing Address - Country:US
Mailing Address - Phone:208-720-7897
Mailing Address - Fax:
Practice Address - Street 1:270 NORTHWOOD WAY
Practice Address - Street 2:
Practice Address - City:KETCHUM
Practice Address - State:ID
Practice Address - Zip Code:83340-7897
Practice Address - Country:US
Practice Address - Phone:208-720-7897
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-08
Last Update Date:2013-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDID111171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist