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NPI Code Detail

MEDICARE: JEREMY WAYNE SCHMIDT DPT

MEDICARE:   JEREMY WAYNE SCHMIDT  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
1225100000XPhysical Therapist10495CO

General Provider Information

NPI Number : 1366672487
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEREMY WAYNE SCHMIDT DPT
Provider Business Mailing Address
First Line : 1130 DAYTON ST
Second Line :
City : AURORA
State : CO
Zip : 80010-3205
Country : US
Telephone Number : 913-461-7579
Fax Number : 303-663-8289
Provider Business Practice Location Address
First Line : 4284 TRAIL BOSS DR
Second Line : STE 130
City : CASTLE ROCK
State : CO
Zip : 80104-7521
Country : US
Telephone Number : 303-663-8289
Fax Number : 303-663-8289
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/23/2009
Last Update Date : 07/23/2009

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Directions to “ JEREMY WAYNE SCHMIDT DPT” Practice Location

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