Healthcare Provider Details

I. General information

NPI: 1407003932
Provider Name (Legal Business Name): JENNIFER MOEHRING-SCHMIDT PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER MOEHRING

II. Dates (important events)

Enumeration Date: 08/27/2008
Last Update Date: 08/21/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2435 RESEARCH PKWY SUITE 255
COLORADO SPRINGS CO
80920-1070
US

IV. Provider business mailing address

2233 ACADEMY PL STE 50
COLORADO SPRINGS CO
80909-1696
US

V. Phone/Fax

Practice location:
  • Phone: 719-260-8400
  • Fax: 719-260-8405
Mailing address:
  • Phone: 719-475-0808
  • Fax: 719-475-8822

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT 10579
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: