Healthcare Provider Details

I. General information

NPI: 1669334371
Provider Name (Legal Business Name): AMBER SCHOENICKE PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/01/2025
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 CORPORATE DR
BEAVER DAM WI
53916-3116
US

IV. Provider business mailing address

130 CORPORATE DR
BEAVER DAM WI
53916-3116
US

V. Phone/Fax

Practice location:
  • Phone: 920-885-8787
  • Fax:
Mailing address:
  • Phone: 920-885-8787
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number17539-24
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: