Provider Demographics
NPI:1619365301
Name:SCHNEIDER, PATRIK RYAN (DC)
Entity Type:Individual
Prefix:DR
First Name:PATRIK
Middle Name:RYAN
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 1:1333 W LOMBARD ST STE D
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52804-2101
Mailing Address - Country:US
Mailing Address - Phone:563-388-6364
Mailing Address - Fax:563-386-1064
Practice Address - Street 1:1333 W LOMBARD ST STE D
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52804-2101
Practice Address - Country:US
Practice Address - Phone:563-388-6364
Practice Address - Fax:563-386-1064
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-02
Last Update Date:2019-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA076026111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0706363Medicaid