Healthcare Provider Details

I. General information

NPI: 1811221344
Provider Name (Legal Business Name): MARIANN SCHUSTER P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2009
Last Update Date: 09/30/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4125 N 124TH ST STE A
BROOKFIELD WI
53005-1837
US

IV. Provider business mailing address

9862 W ARGONNE DR
WAUWATOSA WI
53222-3425
US

V. Phone/Fax

Practice location:
  • Phone: 262-439-8602
  • Fax:
Mailing address:
  • Phone: 414-442-2046
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number2518-024
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: