Provider Demographics
NPI:1497049001
Name:SCHNEIDER, KEVIN JAMES (DC)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:JAMES
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 1:717 6TH AVE S
Mailing Address - Street 2:
Mailing Address - City:HOPKINS
Mailing Address - State:MN
Mailing Address - Zip Code:55343-7718
Mailing Address - Country:US
Mailing Address - Phone:651-774-7014
Mailing Address - Fax:
Practice Address - Street 1:14440 28TH PL N
Practice Address - Street 2:SUITE 200B
Practice Address - City:PLYMOUTH
Practice Address - State:MN
Practice Address - Zip Code:55447-4854
Practice Address - Country:US
Practice Address - Phone:612-353-4486
Practice Address - Fax:612-465-1603
Is Sole Proprietor?:No
Enumeration Date:2011-06-01
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5555111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor