MEDICARE: MRS. JENNIFER JO SCHNIEDERS DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	117927	MO

General Provider Information

NPI Number	:	1013284215
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JENNIFER JO SCHNIEDERS DPT

Provider Business Mailing Address
First Line	:	1739 ELM CT
Second Line	:	STE 205206
City	:	JEFFERSON CITY
State	:	MO
Zip	:	65101-4303
Country	:	US
Telephone Number	:	573-680-3178
Fax Number	:

Provider Business Practice Location Address
First Line	:	222 DALWHINNE WAYE
Second Line	:
City	:	JEFFERSON CITY
State	:	MO
Zip	:	65101-8287
Country	:	US
Telephone Number	:	573-680-3178
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/17/2011
Last Update Date	:	05/15/2017

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