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General NPI Number Information
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NPI Number | 1225860984
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Entity Type | Individual
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Provider Name | JENNIFER ELAINE SCHRAEDER PTA
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Gender | Female
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Dates
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Enumeration Date | 08/20/2024
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Last Update Date | 08/20/2024
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Provider Practice Location Address
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Address Line | 8741 FERN STREET ROOM 109B
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City | BAUMHOLDER
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State | RHINELAND-PALATINATE
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Zip | 55774
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Country | DE
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Telephone | 314-590-1003
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Fax |
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Provider Business Mailing Address
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Address Line | CMR 405 BOX 6179
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City | APO
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State | AE
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Zip | 09034-0162
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Country | US
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Telephone | 805-757-2481
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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 | A11300
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License Number State | LA
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