Provider Demographics
NPI:1588806418
Name:SCHNEIDER, ELISABETH ANN (DC)
Entity Type:Individual
Prefix:DR
First Name:ELISABETH
Middle Name:ANN
Last Name:SCHNEIDER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1695 MESQUITE AVE STE 114
Mailing Address - Street 2:
Mailing Address - City:LAKE HAVASU CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:86403-5687
Mailing Address - Country:US
Mailing Address - Phone:928-453-6808
Mailing Address - Fax:
Practice Address - Street 1:1695 MESQUITE AVE STE 114
Practice Address - Street 2:
Practice Address - City:LAKE HAVASU CITY
Practice Address - State:AZ
Practice Address - Zip Code:86403-5687
Practice Address - Country:US
Practice Address - Phone:928-453-6808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-24
Last Update Date:2022-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7993111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor