Provider Demographics
NPI:1063678472
Name:SCHOBER, JUSTIN (MPT)
Entity Type:Individual
Prefix:MR
First Name:JUSTIN
Middle Name:
Last Name:SCHOBER
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 E ANSEL AVE
Mailing Address - Street 2:
Mailing Address - City:BREWSTER
Mailing Address - State:WA
Mailing Address - Zip Code:98812-9609
Mailing Address - Country:US
Mailing Address - Phone:509-429-3355
Mailing Address - Fax:888-316-6792
Practice Address - Street 1:1 COULEE BOULEVARD WEST
Practice Address - Street 2:
Practice Address - City:ELECTRIC CITY
Practice Address - State:WA
Practice Address - Zip Code:99123
Practice Address - Country:US
Practice Address - Phone:509-633-9915
Practice Address - Fax:888-316-6792
Is Sole Proprietor?:No
Enumeration Date:2008-08-05
Last Update Date:2012-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00008835225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist