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General NPI Number Information
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NPI Number | 1598049603
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Entity Type | Individual
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Provider Name | NICHOLAS JOHN SCHNEIDER DPT
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Gender | Male
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Dates
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Enumeration Date | 10/07/2011
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Last Update Date | 10/07/2011
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Provider Practice Location Address
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Address Line | 4670 PARK NICOLLET AVE SE
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City | PRIOR LAKE
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State | MN
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Zip | 55372-4119
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Country | US
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Telephone | 952-993-8845
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Fax | 952-993-8811
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Provider Business Mailing Address
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Address Line | 3800 PARK NICOLLET BLVD
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City | ST LOUIS PARK
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State | MN
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Zip | 55416-2527
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 8757
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License Number State | MN
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