Healthcare Provider Details

I. General information

NPI: 1275808461
Provider Name (Legal Business Name): DANIELLE MARIE SCHUSTER PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2012
Last Update Date: 03/20/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 ADAMS AVE
SCRANTON PA
18509-1515
US

IV. Provider business mailing address

612 E WARREN ST
DUNMORE PA
18512-2532
US

V. Phone/Fax

Practice location:
  • Phone: 570-346-5788
  • Fax:
Mailing address:
  • Phone: 570-343-0592
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT017047
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: