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General NPI Number Information
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NPI Number | 1376562363
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Entity Type | Individual
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Provider Name | MICHELLE FORD SCHULZ P.T.
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Gender | Female
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Dates
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Enumeration Date | 07/19/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 101 CIVIC CENTER LN
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City | LAKE HAVASU CITY
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State | AZ
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Zip | 86403-5607
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Country | US
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Telephone | 928-453-0411
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Fax |
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Provider Business Mailing Address
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Address Line | 3830 WINNEBAGO DR
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City | LAKE HAVASU CITY
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State | AZ
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Zip | 86404-3585
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Country | US
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Telephone | 928-453-0411
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 6410
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT22616
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License Number State | CA
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