Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 31760 | AZ |
NPI | 1063086882 |
---|---|
Provider Name | Kevin Allen Schnitz |
First Address | Mesa, AZ 85212-1934 |
Second Address | Queen Creek, AZ 85140-7387 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2021 |
Last Update Date | 17/05/2021 |