Provider Demographics
NPI:1225286776
Name:SCHMITZ, DAVID LEE (PT)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:LEE
Last Name:SCHMITZ
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2120 AIRWAY AVE
Mailing Address - Street 2:
Mailing Address - City:KINGMAN
Mailing Address - State:AZ
Mailing Address - Zip Code:86409-3652
Mailing Address - Country:US
Mailing Address - Phone:928-757-1211
Mailing Address - Fax:928-757-8826
Practice Address - Street 1:2120 AIRWAY AVE
Practice Address - Street 2:
Practice Address - City:KINGMAN
Practice Address - State:AZ
Practice Address - Zip Code:86409-3652
Practice Address - Country:US
Practice Address - Phone:928-757-1211
Practice Address - Fax:928-757-8826
Is Sole Proprietor?:No
Enumeration Date:2008-09-08
Last Update Date:2008-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1614225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist