MEDICARE: DR. JEAN KINZINGER SCHILD PT, DPT

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
1	225100000X	Physical Therapist	PT017635	PA

General Provider Information

NPI Number	:	1497788731
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEAN KINZINGER SCHILD PT, DPT

Provider Business Mailing Address
First Line	:	111 ELWYN RD
Second Line	:	KIVITZ BLDG- PHYS REHAB
City	:	ELWYN
State	:	PA
Zip	:	19063-4622
Country	:	US
Telephone Number	:	610-891-2647
Fax Number	:	610-891-2280

Provider Business Practice Location Address
First Line	:	111 ELWYN RD
Second Line	:	KIVITZ BLDG- PHYS REHAB
City	:	ELWYN
State	:	PA
Zip	:	19063-4622
Country	:	US
Telephone Number	:	610-891-2647
Fax Number	:	610-891-2280

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/09/2006
Last Update Date	:	07/08/2007

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