Healthcare Provider Details

I. General information

NPI: 1275287757
Provider Name (Legal Business Name): MICHELLE SCHMIDT DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/04/2022
Last Update Date: 02/04/2022
Certification Date: 02/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

939 HIGHWAY K
O FALLON MO
63366-2910
US

IV. Provider business mailing address

939 HIGHWAY K
O FALLON MO
63366-2910
US

V. Phone/Fax

Practice location:
  • Phone: 636-240-7000
  • Fax:
Mailing address:
  • Phone: 636-240-7000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2022004163
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: