Provider Demographics
NPI:1942457825
Name:SCHNEIDER, GREGORY PETER (MS, AT)
Entity Type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:PETER
Last Name:SCHNEIDER
Suffix:
Gender:M
Credentials:MS, AT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 E CECIL ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45504-2215
Mailing Address - Country:US
Mailing Address - Phone:614-582-7145
Mailing Address - Fax:
Practice Address - Street 1:250 BILL EDWARDS DR
Practice Address - Street 2:WITTENBERG UNIVERSITY ATHLETICS
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45504-2130
Practice Address - Country:US
Practice Address - Phone:614-582-7145
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-22
Last Update Date:2012-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAT0034012255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer