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NPI Code Detail

MEDICARE: MRS. BRENDA LEE SCHILDER P.T.

MEDICARE: MRS. BRENDA LEE SCHILDER 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
1251C00000XDevelopmentally Disabled Services Day Training Agency4764-024WI

General Provider Information

NPI Number : 1811901523
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. BRENDA LEE SCHILDER P.T.
Provider Business Mailing Address
First Line : 735 SUNSET DR
Second Line :
City : PLYMOUTH
State : WI
Zip : 53073-1022
Country : US
Telephone Number : 920-892-8070
Fax Number :
Provider Business Practice Location Address
First Line : 1125 N 13TH ST
Second Line :
City : SHEBOYGAN
State : WI
Zip : 53081-3281
Country : US
Telephone Number : 920-208-9648
Fax Number : 920-208-6316
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/28/2006
Last Update Date : 07/08/2007

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