Provider Demographics
NPI:1093437907
Name:SCHWARTZKOPF, TAYLOR JEWELL LILLIAN (PTA)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:JEWELL LILLIAN
Last Name:SCHWARTZKOPF
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8461 RENNER BLVD APT 4305
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66219-8538
Mailing Address - Country:US
Mailing Address - Phone:573-366-4833
Mailing Address - Fax:
Practice Address - Street 1:16801 W 116TH ST
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66219-9603
Practice Address - Country:US
Practice Address - Phone:913-538-0777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-16
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS14-04036225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant