Provider Demographics
NPI:1063291169
Name:SCHNEIDER, ROBERT GREG (DC)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:GREG
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 1:6560 N SCOTTSDALE RD STE 125
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85253-4484
Mailing Address - Country:US
Mailing Address - Phone:314-809-9909
Mailing Address - Fax:
Practice Address - Street 1:6560 N SCOTTSDALE RD STE 125
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85253-4484
Practice Address - Country:US
Practice Address - Phone:314-809-9909
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-27
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3513111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor