MEDICARE: TERI KRISTINA SCHUELLER OTR/L

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	282N00000X	General Acute Care Hospital	103859	MN
2	273Y00000X	Rehabilitation Hospital Unit	103859	MN

General Provider Information

NPI Number	:	1639492853
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERI KRISTINA SCHUELLER OTR/L

Provider Business Mailing Address
First Line	:	29157 250TH ST
Second Line	:
City	:	WABASSO
State	:	MN
Zip	:	56293-1271
Country	:	US
Telephone Number	:	507-828-3965
Fax Number	:

Provider Business Practice Location Address
First Line	:	29157 250TH ST
Second Line	:
City	:	WABASSO
State	:	MN
Zip	:	56293-1271
Country	:	US
Telephone Number	:	507-828-3965
Fax Number	:

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

Provider Enumeration Date	:	03/02/2010
Last Update Date	:	03/02/2010

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