Healthcare Provider Details

I. General information

NPI: 1700457751
Provider Name (Legal Business Name): ALEXIS SCHAFFER DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2021
Last Update Date: 08/31/2021
Certification Date: 08/31/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 N KIMBALL ST
MITCHELL SD
57301-1164
US

IV. Provider business mailing address

2100 N KIMBALL ST
MITCHELL SD
57301-1164
US

V. Phone/Fax

Practice location:
  • Phone: 605-996-8712
  • Fax:
Mailing address:
  • Phone: 605-996-8712
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number2322
License Number StateSD

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: