MEDICARE: JOAN SCHMIDT ORTHOPEDIC PHYSICAL THERAPY

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

General Provider Information

NPI Number	:	1982617569
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOAN SCHMIDT ORTHOPEDIC PHYSICAL THERAPY

Provider Business Mailing Address
First Line	:	11500 W OLYMPIC BLVD # 636
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90064-1524
Country	:	US
Telephone Number	:	310-996-0085
Fax Number	:	310-996-1064

Provider Business Practice Location Address
First Line	:	11500 W OLYMPIC BLVD # 636
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90064-1524
Country	:	US
Telephone Number	:	310-996-0085
Fax Number	:	310-996-1064

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. JOAN ELAINE SCHMIDT
Credential	:	P.T.
Telephone Number	:	310-996-0085

Provider Enumeration Date	:	08/14/2006
Last Update Date	:	07/22/2008

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