Healthcare Provider Details

I. General information

NPI: 1265894588
Provider Name (Legal Business Name): KRISTI SCHULZE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/25/2016
Last Update Date: 03/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 COLEMAN'S CROSSING BLVD.
MARYSVILLE OH
43040
US

IV. Provider business mailing address

20521 NORTHWEST PKWY
MARYSVILLE OH
43040-9159
US

V. Phone/Fax

Practice location:
  • Phone: 937-578-7841
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number07296
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: