Healthcare Provider Details

I. General information

NPI: 1720534829
Provider Name (Legal Business Name): KRISTIN SCHADE PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2016
Last Update Date: 01/20/2026
Certification Date: 01/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1477 N 2000 W STE A
CLINTON UT
84015-9099
US

IV. Provider business mailing address

2127 W NATALIE AVE
SYRACUSE UT
84075-1101
US

V. Phone/Fax

Practice location:
  • Phone: 801-773-4191
  • Fax: 801-773-4197
Mailing address:
  • Phone: 801-380-0330
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number12521
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number9626976-2401
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: