Healthcare Provider Details

I. General information

NPI: 1770696627
Provider Name (Legal Business Name): BERNADETTE M. SCHWAI MPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BERNADETTE M. MARSIGLIA

II. Dates (important events)

Enumeration Date: 08/16/2006
Last Update Date: 04/23/2020
Certification Date: 04/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

209 SOLAR DR
WALKERSVILLE MD
21793-8000
US

IV. Provider business mailing address

4000 N. PROVIDENCE AVENUE
APPLETON WI
54913-8018
US

V. Phone/Fax

Practice location:
  • Phone: 240-439-5825
  • Fax: 201-233-1234
Mailing address:
  • Phone: 920-257-2000
  • Fax: 920-257-2004

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number10323-024
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number19443
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: