Healthcare Provider Details

I. General information

NPI: 1861777401
Provider Name (Legal Business Name): ROBERT SCHNITZLER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/14/2011
Last Update Date: 10/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1715 26TH ST
CENTRAL CITY NE
68826-9501
US

IV. Provider business mailing address

1017 20TH ST
CENTRAL CITY NE
68826-9517
US

V. Phone/Fax

Practice location:
  • Phone: 308-946-3015
  • Fax:
Mailing address:
  • Phone: 308-946-3565
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number951
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: