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General NPI Number Information
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NPI Number | 1730902743
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Entity Type | Individual
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Provider Name | JONATHON EDWARD SCHROEDER PT, DPT
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Gender | Male
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Dates
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Enumeration Date | 11/07/2024
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Last Update Date | 11/07/2024
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Provider Practice Location Address
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Address Line | 801 N STATE ST
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City | GREENFIELD
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State | IN
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Zip | 46140-1270
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Country | US
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Telephone | 317-468-4472
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Fax |
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Provider Business Mailing Address
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Address Line | 3860 N COUNTY ROAD 300 W
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City | NORTH VERNON
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State | IN
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Zip | 47265-7385
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Country | US
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Telephone | 812-767-4887
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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 | 05011832A
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License Number State | IN
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