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General NPI Number Information
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NPI Number | 1861780421
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Entity Type | Individual
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Provider Name | TIFFANY SCHROEDER ATC, LAT, DPT, PT
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Gender | Female
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Dates
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Enumeration Date | 07/18/2011
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Last Update Date | 07/18/2011
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Provider Practice Location Address
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Address Line | 3965 S MENDENHALL RD
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City | MEMPHIS
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State | TN
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Zip | 38115-5914
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Country | US
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Telephone | 901-365-1800
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 38832
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City | GERMANTOWN
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State | TN
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Zip | 38183-0832
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Country | US
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Telephone |
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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 | 8961
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 1256
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License Number State | TN
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