Provider Demographics
NPI:1003828963
Name:FRITTER, SCHULZ & CONLAN PHYSICAL & OCCUPATIONAL THERAPY
Entity Type:Organization
Organization Name:FRITTER, SCHULZ & CONLAN PHYSICAL & OCCUPATIONAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GLENN
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHULZ
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:408-847-0107
Mailing Address - Street 1:18550 DE PAUL DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MORGAN HILL
Mailing Address - State:CA
Mailing Address - Zip Code:95037-2911
Mailing Address - Country:US
Mailing Address - Phone:408-779-4343
Mailing Address - Fax:408-847-0107
Practice Address - Street 1:18550 DE PAUL DR
Practice Address - Street 2:SUITE 100
Practice Address - City:MORGAN HILL
Practice Address - State:CA
Practice Address - Zip Code:95037-2911
Practice Address - Country:US
Practice Address - Phone:408-779-4343
Practice Address - Fax:408-847-0107
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-12
Last Update Date:2009-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT9291225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ22778ZMedicare PIN