Provider Demographics
NPI:1821489428
Name:SCHNEIBLE, CASEY LEE
Entity Type:Individual
Prefix:
First Name:CASEY
Middle Name:LEE
Last Name:SCHNEIBLE
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 1:4724 PARK RD UNIT B1
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28209-2265
Mailing Address - Country:US
Mailing Address - Phone:704-980-9049
Mailing Address - Fax:
Practice Address - Street 1:4724 PARK RD UNIT B1
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28209-2265
Practice Address - Country:US
Practice Address - Phone:704-980-9049
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-18
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4599111N00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program