MEDICARE: MRS. JULI ANN SCHLUCKEBIER 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	PT002599	KY
2	225100000X	Physical Therapist	PT 1113	AR

General Provider Information

NPI Number	:	1881761666
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JULI ANN SCHLUCKEBIER P.T.

Provider Business Mailing Address
First Line	:	5912 WALL ST
Second Line	:
City	:	BENTON
State	:	AR
Zip	:	72019-6598
Country	:	US
Telephone Number	:	501-847-2304
Fax Number	:

Provider Business Practice Location Address
First Line	:	17706 I-30 STE 3
Second Line	:
City	:	BENTON
State	:	AR
Zip	:	72019-2930
Country	:	US
Telephone Number	:	501-315-4414
Fax Number	:

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

Provider Enumeration Date	:	11/29/2006
Last Update Date	:	01/26/2008

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Directions to “ MRS. JULI ANN SCHLUCKEBIER P.T.” Practice Location

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