Provider Demographics
NPI:1457938722
Name:SCHNEIDER CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:SCHNEIDER CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHNEIDER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:636-352-3014
Mailing Address - Street 1:12505 LIGHTHOUSE WAY DR APT F
Mailing Address - Street 2:
Mailing Address - City:CREVE COEUR
Mailing Address - State:MO
Mailing Address - Zip Code:63141-5403
Mailing Address - Country:US
Mailing Address - Phone:636-325-3014
Mailing Address - Fax:
Practice Address - Street 1:5252 MEXICO ROAD
Practice Address - Street 2:
Practice Address - City:ST. PETERS
Practice Address - State:MO
Practice Address - Zip Code:63376
Practice Address - Country:US
Practice Address - Phone:636-978-5511
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-24
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty