MEDICARE: MRS. KATHRYN SARA SCHURMAN P.T.

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	4235	MN

General Provider Information

NPI Number	:	1538279971
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KATHRYN SARA SCHURMAN P.T.

Provider Business Mailing Address
First Line	:	180 1ST ST
Second Line	:
City	:	EXCELSIOR
State	:	MN
Zip	:	55331-1772
Country	:	US
Telephone Number	:	612-986-4567
Fax Number	:

Provider Business Practice Location Address
First Line	:	790 MINNESOTA AVE
Second Line	:
City	:	BIG LAKE
State	:	MN
Zip	:	55309-8832
Country	:	US
Telephone Number	:	763-263-3684
Fax Number	:

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

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	07/08/2007

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