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General NPI Number Information
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NPI Number | 1528244761
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Entity Type | Organization
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Legal Business Name | GAYLAIN LEE SHUMACHER PHYSICAL THERAPIST
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Dates
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Enumeration Date | 01/17/2008
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 2722 LANE ST
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City | PALATKA
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State | FL
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Zip | 32177-2810
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Country | US
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Telephone | 386-325-6369
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Fax | 386-329-8922
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Provider Business Mailing Address
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Address Line | 2722 LANE ST
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City | PALATKA
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State | FL
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Zip | 32177-2810
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Country | US
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Telephone | 386-325-6369
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Fax | 386-329-8922
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Authorized Official
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Title or Position | OWNER
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Name | MR. GAYLAIN LEE SCHUMACHER
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Credential | P.T
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Telephone | 386-325-6369
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | PT3591
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License Number State | FL
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