MEDICARE: JENNIFER SCHRODER LAT

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	225500000X	Respiratory/Developmental/Rehabilitative Specialist/Technologist	64	MT

General Provider Information

NPI Number	:	1912324385
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER SCHRODER LAT

Provider Business Mailing Address
First Line	:	536 S COTTONWOOD RD
Second Line	:	#100
City	:	BOZEMAN
State	:	MT
Zip	:	59718-9515
Country	:	US
Telephone Number	:	406-586-8029
Fax Number	:	406-586-8009

Provider Business Practice Location Address
First Line	:	536 S COTTONWOOD RD
Second Line	:	#100
City	:	BOZEMAN
State	:	MT
Zip	:	59718-9515
Country	:	US
Telephone Number	:	406-586-8029
Fax Number	:	406-586-8009

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

Provider Enumeration Date	:	03/24/2014
Last Update Date	:	03/24/2014

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