Provider Demographics
NPI:1114315504
Name:SCHNEIDER CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:SCHNEIDER CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRIK
Authorized Official - Middle Name:RYAN
Authorized Official - Last Name:SCHNEIDER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:563-388-6364
Mailing Address - Street 1:1333 W LOMBARD ST STE D
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52804-2101
Mailing Address - Country:US
Mailing Address - Phone:563-338-6364
Mailing Address - Fax:563-386-1064
Practice Address - Street 1:1333 W LOMBARD ST STE D
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52804-2101
Practice Address - Country:US
Practice Address - Phone:563-338-6364
Practice Address - Fax:563-386-1064
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-07
Last Update Date:2019-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA076026111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty