MEDICARE: DR. HOLLY JEAN SCHMITZ 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
1	225100000X	Physical Therapist	1490	SD
2	225100000X	Physical Therapist	4415	IA

General Provider Information

NPI Number	:	1700119039
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HOLLY JEAN SCHMITZ DPT

Provider Business Mailing Address
First Line	:	31861 HENKE RD
Second Line	:
City	:	ELK POINT
State	:	SD
Zip	:	57025-6619
Country	:	US
Telephone Number	:	605-565-2024
Fax Number	:

Provider Business Practice Location Address
First Line	:	31861 HENKE RD
Second Line	:
City	:	ELK POINT
State	:	SD
Zip	:	57025-6619
Country	:	US
Telephone Number	:	605-565-2024
Fax Number	:

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

Provider Enumeration Date	:	09/18/2009
Last Update Date	:	10/26/2009

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Directions to “ DR. HOLLY JEAN SCHMITZ DPT” Practice Location

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