Provider Demographics
NPI:1861717894
Name:LANDER, KRISTIN EMMEL SCHAFFER (DC)
Entity type:Individual
Prefix:DR
First Name:KRISTIN
Middle Name:EMMEL SCHAFFER
Last Name:LANDER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:KRISTIN
Other - Middle Name:EMMEL
Other - Last Name:SCHAFFER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:206 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WALHALLA
Mailing Address - State:SC
Mailing Address - Zip Code:29691-1931
Mailing Address - Country:US
Mailing Address - Phone:864-638-6500
Mailing Address - Fax:
Practice Address - Street 1:206 W MAIN ST
Practice Address - Street 2:
Practice Address - City:WALHALLA
Practice Address - State:SC
Practice Address - Zip Code:29691-1931
Practice Address - Country:US
Practice Address - Phone:864-638-6500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-01
Last Update Date:2015-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5356111N00000X
SC4025111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCSC5637E620Medicare PIN