Individual
GAVIN RANDALL SCHNEIDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
13205 F ST, OMAHA, NE 68137-1131
(402) 590-5818
Mailing address
13585 GOLD ST, OMAHA, NE 68144-2431
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3896
NE
225100000X
Physical Therapist
62255
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3896
NEBRASKA DEPARTMENT OF HEALTH & HUMAN SERVICES
NE
01
—
62255
STATE OF OREGON LICENSE
OR
Enumeration date
06/11/2017
Last updated
11/24/2020
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