MEDICARE: SCHAFER PHYSICAL THERAPY LLC

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

General Provider Information

NPI Number	:	1013960731
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SCHAFER PHYSICAL THERAPY LLC

Provider Business Mailing Address
First Line	:	PO BOX 157
Second Line	:
City	:	BROWNSVILLE
State	:	KY
Zip	:	42210-0157
Country	:	US
Telephone Number	:	270-597-9676
Fax Number	:	270-597-9686

Provider Business Practice Location Address
First Line	:	105 MOHAWK ST
Second Line	:	SUITE A
City	:	BROWNSVILLE
State	:	KY
Zip	:	42210-8544
Country	:	US
Telephone Number	:	270-597-9676
Fax Number	:	270-597-9686

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JEREMY L SCHAFER
Credential	:	MPT, OCS
Telephone Number	:	270-597-9676

Provider Enumeration Date	:	05/17/2006
Last Update Date	:	08/22/2020

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