Healthcare Provider Details

I. General information

NPI: 1760022537
Provider Name (Legal Business Name): COLTON SCHNETZER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2020
Last Update Date: 08/03/2021
Certification Date: 08/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3815 STANGE RD
AMES IA
50010-3914
US

IV. Provider business mailing address

5627 NW 86TH ST STE 200
JOHNSTON IA
50131-1738
US

V. Phone/Fax

Practice location:
  • Phone: 515-956-4970
  • Fax: 515-956-4988
Mailing address:
  • Phone: 630-575-1980
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: