Provider Demographics
NPI:1164771317
Name:SCHNEIDER, KYLE EDWARD (DC)
Entity Type:Individual
Prefix:DR
First Name:KYLE
Middle Name:EDWARD
Last Name:SCHNEIDER
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 1:6508 DETROIT AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44102-3014
Mailing Address - Country:US
Mailing Address - Phone:216-334-1401
Mailing Address - Fax:216-334-1409
Practice Address - Street 1:6508 DETROIT AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44102-3014
Practice Address - Country:US
Practice Address - Phone:216-334-1401
Practice Address - Fax:216-334-1409
Is Sole Proprietor?:No
Enumeration Date:2012-09-04
Last Update Date:2013-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4373111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor