Healthcare Provider Details

I. General information

NPI: 1134326051
Provider Name (Legal Business Name): KYLE THOMAS SCHUMM MPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3710 OLENTANGY RIVER RD
COLUMBUS OH
43214-3450
US

IV. Provider business mailing address

4652 CHERRY GLEN DR
POWELL OH
43065-7464
US

V. Phone/Fax

Practice location:
  • Phone: 614-457-1100
  • Fax:
Mailing address:
  • Phone: 740-881-4293
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License Number10292
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: