=====================================================
General NPI Number Information
=====================================================
NPI Number | 1689249997
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CJS PHYSICAL THERAPY SERVICES INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/20/2021
-----------------------------------------------------
Last Update Date | 07/21/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 91 POINT JUDITH RD UNIT D7
-----------------------------------------------------
City | NARRAGANSETT
-----------------------------------------------------
State | RI
-----------------------------------------------------
Zip | 02882-3468
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 401-824-6335
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 91 POINT JUDITH RD # D7
-----------------------------------------------------
City | NARRAGANSETT
-----------------------------------------------------
State | RI
-----------------------------------------------------
Zip | 02882-3468
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 401-824-6335
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | CONOR SCHMIDT
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 401-584-9098
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------