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General NPI Number Information
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NPI Number | 1225650518
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Entity Type | Individual
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Provider Name | ZACHARY SCHMUCKER DPT
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Gender | Male
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Dates
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Enumeration Date | 05/11/2020
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Last Update Date | 06/24/2020
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Provider Practice Location Address
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Address Line | 12722 TONKEL RD STE 102
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City | FORT WAYNE
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State | IN
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Zip | 46845-8201
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Country | US
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Telephone | 260-739-0300
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Fax |
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Provider Business Mailing Address
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Address Line | 53564 STATE ROAD 13
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City | MIDDLEBURY
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State | IN
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Zip | 46540-8931
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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 | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number |
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License Number State |
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