Healthcare Provider Details

I. General information

NPI: 1134787716
Provider Name (Legal Business Name): CARLY JEAN SCHAMS DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2019
Last Update Date: 06/18/2025
Certification Date: 06/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14101 FAIRVIEW DR STE 300
BURNSVILLE MN
55337-2537
US

IV. Provider business mailing address

14101 FAIRVIEW DR STE 300
BURNSVILLE MN
55337-2537
US

V. Phone/Fax

Practice location:
  • Phone: 612-273-6228
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number11453
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: