Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 2417 | MN |
NPI | 1003859786 |
---|---|
Provider Name | Dr. Joseph Anthony Schneiderhan |
First Address | Glenwood, MN 56334-1558 |
Second Address | Glenwood, MN 56334-1558 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2006 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
597816500 | (05) | MN |
U37290 | (02) | MN |