MEDICARE: JENNIFER D SCHNELL LMT#20190

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	225700000X	Massage Therapist	20190	OR

General Provider Information

NPI Number	:	1538607106
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER D SCHNELL LMT#20190

Provider Business Mailing Address
First Line	:	516 MARY ST
Second Line	:
City	:	MEDFORD
State	:	OR
Zip	:	97504-6828
Country	:	US
Telephone Number	:	541-499-2272
Fax Number	:

Provider Business Practice Location Address
First Line	:	155 ALTA VISTA RD STE B
Second Line	:
City	:	EAGLE POINT
State	:	OR
Zip	:	97524-9735
Country	:	US
Telephone Number	:	541-879-3443
Fax Number	:

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

Provider Enumeration Date	:	02/03/2017
Last Update Date	:	07/22/2022

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