=====================================================
General NPI Number Information
=====================================================
NPI Number | 1073978722
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SCHNEIDERS INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/23/2015
-----------------------------------------------------
Last Update Date | 12/23/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 60 MAIN ST SUITE 64
-----------------------------------------------------
City | WINDSOR LOCKS
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06096-2354
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 860-752-6353
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 60 MAIN ST SUITE 64
-----------------------------------------------------
City | WINDSOR LOCKS
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06096-2354
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 860-752-6353
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | HOLLEE L SCHNEIDER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 860-752-6353
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225700000X
-----------------------------------------------------
Taxonomy Name | Massage Therapist
-----------------------------------------------------
License Number | 7287
-----------------------------------------------------
License Number State | CT
-----------------------------------------------------