Healthcare Provider Details

I. General information

NPI: 1336300268
Provider Name (Legal Business Name): MARK ALAN SCHNURR P.T., R.D., C.S.C.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2008
Last Update Date: 07/31/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1420 N 10TH ST
NEBRASKA CITY NE
68410-1236
US

IV. Provider business mailing address

157 HICKORY RIDGE DR
GLENWOOD IA
51534-5409
US

V. Phone/Fax

Practice location:
  • Phone: 402-873-3304
  • Fax:
Mailing address:
  • Phone: 402-659-2694
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number03163
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: