MEDICARE: JOHN MICHAEL SCHRUTH MS,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	225100000X	Physical Therapist	PT00000822	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	60362	OTHER	WA	LABOR AND INDUSTRIES
2	911486101 0007	OTHER	WA	CIGNA
3	146129146129	OTHER	WA	PREMERA
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1942335112
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN MICHAEL SCHRUTH MS,PT

Provider Business Mailing Address
First Line	:	2204 E 29TH AVE
Second Line	:	SUITE 202
City	:	SPOKANE
State	:	WA
Zip	:	99203-3961
Country	:	US
Telephone Number	:	509-536-1761
Fax Number	:	509-536-1763

Provider Business Practice Location Address
First Line	:	2204 E 29TH AVE
Second Line	:	SUITE 202
City	:	SPOKANE
State	:	WA
Zip	:	99203-3961
Country	:	US
Telephone Number	:	509-536-1761
Fax Number	:	509-536-1763

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

Provider Enumeration Date	:	02/21/2007
Last Update Date	:	07/08/2007

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