Provider Demographics
NPI:1134326051
Name:SCHUMM, KYLE THOMAS (MPT)
Entity Type:Individual
Prefix:
First Name:KYLE
Middle Name:THOMAS
Last Name:SCHUMM
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 1:4652 CHERRY GLEN DR
Mailing Address - Street 2:
Mailing Address - City:POWELL
Mailing Address - State:OH
Mailing Address - Zip Code:43065-7464
Mailing Address - Country:US
Mailing Address - Phone:740-881-4293
Mailing Address - Fax:
Practice Address - Street 1:3710 OLENTANGY RIVER RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-3450
Practice Address - Country:US
Practice Address - Phone:614-457-1100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH102922251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics