Provider Demographics
NPI:1417487497
Name:SCHNITZLER, ROBERT TYLER
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:TYLER
Last Name:SCHNITZLER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1597 SHELDON LN
Mailing Address - Street 2:
Mailing Address - City:CATLETT
Mailing Address - State:VA
Mailing Address - Zip Code:20119-2442
Mailing Address - Country:US
Mailing Address - Phone:814-777-4064
Mailing Address - Fax:
Practice Address - Street 1:9413 INNOVATION DR
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110-2224
Practice Address - Country:US
Practice Address - Phone:571-295-5843
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-13
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104557409111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0104557409OtherVIRGINIA LICENSE