MEDICARE: JOAN SCHAEFER DALTON 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	1017	KY

General Provider Information

NPI Number	:	1861556227
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOAN SCHAEFER DALTON P.T.

Provider Business Mailing Address
First Line	:	PO BOX 950248
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40295-0248
Country	:	US
Telephone Number	:	502-489-5730
Fax Number	:	502-489-5733

Provider Business Practice Location Address
First Line	:	11630 COMMONWEALTH DR
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40299-2300
Country	:	US
Telephone Number	:	502-267-6292
Fax Number	:	502-267-6428

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

Provider Enumeration Date	:	12/20/2006
Last Update Date	:	12/03/2020

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