MEDICARE: SCHAFER PHYSICAL THERAPY, LLC

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	004222	KY

General Provider Information

NPI Number	:	1518097823
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SCHAFER PHYSICAL THERAPY, LLC

Provider Business Mailing Address
First Line	:	PO BOX 157
Second Line	:
City	:	BROWNSVILLE
State	:	KY
Zip	:	42210-0157
Country	:	US
Telephone Number	:	502-287-8115
Fax Number	:

Provider Business Practice Location Address
First Line	:	520 SOUTH MAIN STREET
Second Line	:
City	:	BROWNSVILLE
State	:	KY
Zip	:	42210-9001
Country	:	US
Telephone Number	:	270-597-3757
Fax Number	:	270-597-1020

Authorized Official
Title or Position	:	OWNER
Name	:	JEREMY SCHAFER
Credential	:	MPT
Telephone Number	:	502-287-8122

Provider Enumeration Date	:	03/06/2007
Last Update Date	:	03/28/2013

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