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NPI 1982804902

NPI 1982804902 : LISA LORRAINE SCHNEIDER PT : SAINT CLOUD, MN

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General NPI Number Information
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    NPI Number           |    1982804902
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    Entity Type          |    Individual 
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    Provider Name        |    LISA LORRAINE SCHNEIDER PT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    07/18/2007
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    Last Update Date     |    07/18/2007
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Provider Practice Location Address
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    Address Line         |    1810 MINNESOTA BLVD 
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    City                 |    SAINT CLOUD
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    State                |    MN
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    Zip                  |    56304-2436
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    Country              |    US
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    Telephone            |    320-229-8300
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1271 HUNTINGTON DR S 
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    City                 |    SARTELL
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    State                |    MN
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    Zip                  |    56377-2055
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    Country              |    US
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    Telephone            |    320-230-0395
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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       |    7219
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    License Number State |    MN
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