Provider Demographics
NPI:1568740165
Name:SCHNEIDER, JOSHUA P (LAC)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:P
Last Name:SCHNEIDER
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 GARDEN CTR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80020-7086
Mailing Address - Country:US
Mailing Address - Phone:303-506-0622
Mailing Address - Fax:
Practice Address - Street 1:60 GARDEN CTR
Practice Address - Street 2:SUITE 101
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80020-7086
Practice Address - Country:US
Practice Address - Phone:303-506-0622
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-30
Last Update Date:2016-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14219171100000X
COACU.0001889171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist