Healthcare Provider Details

I. General information

NPI: 1760632228
Provider Name (Legal Business Name): KRISTY LOVE SCHNEIDER PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KRISTY LOVE-SCHNEIDER PT,DPT

II. Dates (important events)

Enumeration Date: 09/22/2008
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 COOPER RD
PICAYUNE MS
39466-2205
US

IV. Provider business mailing address

2001 COOPER RD
PICAYUNE MS
39466-2205
US

V. Phone/Fax

Practice location:
  • Phone: 769-242-2772
  • Fax: 769-242-0513
Mailing address:
  • Phone: 769-242-2772
  • Fax: 769-242-0513

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number6121
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: