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NPI Code Detail

MEDICARE: MR. JAMES SCHRECK PT

MEDICARE: MR. JAMES SCHRECK PT
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
1225100000XPhysical Therapist009337OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1009337OTHEROHSTATE OF OHIO PT LICENSE

General Provider Information

NPI Number : 1316410301
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JAMES SCHRECK PT
Provider Business Mailing Address
First Line : 7057 VAIL CT
Second Line :
City : CINCINNATI
State : OH
Zip : 45247-3325
Country : US
Telephone Number : 513-702-3677
Fax Number :
Provider Business Practice Location Address
First Line : 4320 BRIDGETOWN RD
Second Line :
City : CINCINNATI
State : OH
Zip : 45211-4428
Country : US
Telephone Number : 513-574-4550
Fax Number : 513-574-4735
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/02/2019
Last Update Date : 01/02/2019

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