MEDICARE: JASON SCHWARTZKOPF PT

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	225X00000X	Occupational Therapist	31004412A	IN

General Provider Information

NPI Number	:	1932496874
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JASON SCHWARTZKOPF PT

Provider Business Mailing Address
First Line	:	6005 S SULLIVAN PL
Second Line	:
City	:	TERRE HAUTE
State	:	IN
Zip	:	47802-9700
Country	:	US
Telephone Number	:	317-213-9012
Fax Number	:

Provider Business Practice Location Address
First Line	:	3300 POPLAR ST
Second Line	:
City	:	TERRE HAUTE
State	:	IN
Zip	:	47803-2340
Country	:	US
Telephone Number	:	812-235-6281
Fax Number	:

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

Provider Enumeration Date	:	06/29/2011
Last Update Date	:	06/29/2011

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Directions to “ JASON SCHWARTZKOPF PT” Practice Location

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