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General NPI Number Information
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NPI Number | 1073398012
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Entity Type | Individual
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Provider Name | AUSTIN THEODORE SCHMITT PT, DPT, LAT, ATC
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Gender | Male
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Dates
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Enumeration Date | 08/28/2023
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Last Update Date | 05/28/2025
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Provider Practice Location Address
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Address Line | 1265 LOMBARDI AVE
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City | GREEN BAY
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State | WI
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Zip | 54304-3927
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Country | US
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Telephone | 920-569-7500
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Fax |
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Provider Business Mailing Address
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Address Line | 2100 HOLMGREN WAY UNIT 111
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City | GREEN BAY
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State | WI
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Zip | 54304-4649
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Country | US
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Telephone | 320-226-7684
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 3261-39
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 2251S0007X
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Taxonomy Name | Sports Physical Therapist
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License Number | 17242-24
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License Number State | WI
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