Healthcare Provider Details

I. General information

NPI: 1760428775
Provider Name (Legal Business Name): TRACIE L SCHMITT PT,DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2006
Last Update Date: 01/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6003 PLEASANT COLONY CT SUITE 3
CRESTWOOD KY
40014-8678
US

IV. Provider business mailing address

5612 POPLAR LAKES LN
LOUISVILLE KY
40299-5756
US

V. Phone/Fax

Practice location:
  • Phone: 502-241-5597
  • Fax: 502-241-6499
Mailing address:
  • Phone: 502-727-1012
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number004553
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: