Provider Demographics
NPI:1881640969
Name:SCHNEIDER, JAMES BRIAN (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:BRIAN
Last Name:SCHNEIDER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4835 CASCADE RD SE
Mailing Address - Street 2:SUITE #2
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546-3764
Mailing Address - Country:US
Mailing Address - Phone:616-949-9010
Mailing Address - Fax:919-949-9012
Practice Address - Street 1:4835 CASCADE RD SE
Practice Address - Street 2:SUITE #2
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-3764
Practice Address - Country:US
Practice Address - Phone:616-949-9010
Practice Address - Fax:919-949-9012
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIJS008108111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4412496Medicaid
MI4412496Medicaid