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General NPI Number Information
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NPI Number | 1174881734
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Entity Type | Individual
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Provider Name | STACY A SCHROEDER PTA
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Gender | Female
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Dates
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Enumeration Date | 05/01/2012
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Last Update Date | 03/24/2025
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Provider Practice Location Address
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Address Line | 2502 E PIKES PEAK AVE
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City | COLORADO SPRINGS
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State | CO
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Zip | 80909-6033
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Country | US
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Telephone | 731-267-6066
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Fax |
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Provider Business Mailing Address
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Address Line | 165 AREQUA RIDGE DR
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City | COLORADO SPRINGS
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State | CO
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Zip | 80919-1901
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Country | US
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Telephone |
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 5010
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 12268
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 2092618
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License Number State | TX
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