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General NPI Number Information
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NPI Number | 1720376627
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Entity Type | Individual
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Provider Name | JESSICA LEA SCHROEDER DPT
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Gender | Female
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Dates
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Enumeration Date | 07/13/2011
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Last Update Date | 01/19/2021
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Provider Practice Location Address
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Address Line | 2854 CORAL CT STE 1
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City | CORALVILLE
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State | IA
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Zip | 52241-2809
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Country | US
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Telephone | 319-259-6224
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Fax |
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Provider Business Mailing Address
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Address Line | 8434 CORCORAN RD
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City | WILLOW SPRINGS
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State | IL
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Zip | 60480-1666
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Country | US
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Telephone | 708-467-0657
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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 | 23678
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License Number State | MD
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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 | 070020795
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License Number State | IL
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