Provider Demographics
NPI:1730211814
Name:SCHILO, RICHARD L JR (DC, BS)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:L
Last Name:SCHILO
Suffix:JR
Gender:M
Credentials:DC, BS
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 2736
Mailing Address - Street 2:
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30102-0013
Mailing Address - Country:US
Mailing Address - Phone:770-529-3231
Mailing Address - Fax:
Practice Address - Street 1:715A BASCOMB COMMERCIAL PKWY
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30189-2466
Practice Address - Country:US
Practice Address - Phone:770-924-9400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2011-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR007375111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor