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General NPI Number Information
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NPI Number | 1780451583
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Entity Type | Individual
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Provider Name | JENELLE SCHROEDER LMT
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Gender | Female
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Dates
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Enumeration Date | 12/11/2023
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Last Update Date | 12/11/2023
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Provider Practice Location Address
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Address Line | 207 W MAIN ST
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City | HORTONVILLE
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State | WI
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Zip | 54944-9413
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Country | US
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Telephone | 920-557-0797
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Fax |
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Provider Business Mailing Address
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Address Line | 9 BREYERWOOD CT
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City | HORTONVILLE
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State | WI
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Zip | 54944-9421
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Country | US
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Telephone | 920-636-9262
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 17329-146
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License Number State | WI
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