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NPI Code Detail

MEDICARE: JENNIFER LEA SCHEIDERER PT

MEDICARE:   JENNIFER LEA SCHEIDERER  PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist05006689AIN

General Provider Information

NPI Number : 1306853551
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER LEA SCHEIDERER PT
Provider Business Mailing Address
First Line : 7717 MONTCLAIR DR
Second Line :
City : FORT WAYNE
State : IN
Zip : 46804-3530
Country : US
Telephone Number : 260-432-2012
Fax Number :
Provider Business Practice Location Address
First Line : 3030 LAKE AVE STE 24
Second Line :
City : FORT WAYNE
State : IN
Zip : 46805-5428
Country : US
Telephone Number : 260-424-8830
Fax Number : 260-424-8868
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/01/2006
Last Update Date : 07/08/2007

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Directions to “ JENNIFER LEA SCHEIDERER PT” Practice Location

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