Healthcare Provider Details

I. General information

NPI: 1013960731
Provider Name (Legal Business Name): SCHAFER PHYSICAL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 MOHAWK ST SUITE A
BROWNSVILLE KY
42210-8544
US

IV. Provider business mailing address

PO BOX 157
BROWNSVILLE KY
42210-0157
US

V. Phone/Fax

Practice location:
  • Phone: 270-597-9676
  • Fax: 270-597-9686
Mailing address:
  • Phone: 270-597-9676
  • Fax: 270-597-9686

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JEREMY L SCHAFER
Title or Position: PRESIDENT
Credential: MPT, OCS
Phone: 270-597-9676