Provider Demographics
NPI:1164451498
Name:SCHUSTER, COLLEEN A (PT)
Entity Type:Individual
Prefix:
First Name:COLLEEN
Middle Name:A
Last Name:SCHUSTER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1199 MAIN STREET
Mailing Address - Street 2:P.O. BOX 13346
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45013
Mailing Address - Country:US
Mailing Address - Phone:513-863-2273
Mailing Address - Fax:
Practice Address - Street 1:1199 MAIN ST
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45013-1636
Practice Address - Country:US
Practice Address - Phone:513-863-2273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT005602225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHPT005602OtherPHYSICAL THERAPY