MEDICARE: KYLE THOMAS SCHUMM MPT

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	2251G0304X	Geriatric Physical Therapist	10292	OH

General Provider Information

NPI Number	:	1134326051
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KYLE THOMAS SCHUMM MPT

Provider Business Mailing Address
First Line	:	4652 CHERRY GLEN DR
Second Line	:
City	:	POWELL
State	:	OH
Zip	:	43065-7464
Country	:	US
Telephone Number	:	740-881-4293
Fax Number	:

Provider Business Practice Location Address
First Line	:	3710 OLENTANGY RIVER RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43214-3450
Country	:	US
Telephone Number	:	614-457-1100
Fax Number	:

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

Provider Enumeration Date	:	07/03/2007
Last Update Date	:	07/08/2007

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