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General NPI Number Information
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NPI Number | 1649451865
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Entity Type | Organization
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Legal Business Name | GARY C KOHRING & RAYMOND SCHNEIDER PTR
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Dates
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Enumeration Date | 11/15/2007
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Last Update Date | 01/15/2015
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Provider Practice Location Address
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Address Line | 2034 S ALMA SCHOOL RD SUITE 2
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City | MESA
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State | AZ
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Zip | 85210-4004
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Country | US
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Telephone | 480-831-0150
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Fax | 480-839-3492
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Provider Business Mailing Address
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Address Line | 2034 S ALMA SCHOOL RD SUITE 2
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City | MESA
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State | AZ
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Zip | 85210-4004
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Country | US
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Telephone | 480-831-0150
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Fax | 480-839-3492
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | RAYMOND H SCHNEIDER III
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Credential | D.O.
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Telephone | 480-831-0150
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 1683
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License Number State | AZ
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