Provider Demographics
NPI:1275840498
Name:SCHACHT, LAUREN NOELLE (DPT)
Entity Type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:NOELLE
Last Name:SCHACHT
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MS
Other - First Name:LAUREN
Other - Middle Name:NOELLE
Other - Last Name:TRACY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6706 S PARKEDGE CIR
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:WI
Mailing Address - Zip Code:53132-1282
Mailing Address - Country:US
Mailing Address - Phone:608-698-6080
Mailing Address - Fax:
Practice Address - Street 1:N26W23977 WATERTOWN RD
Practice Address - Street 2:
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53188-1006
Practice Address - Country:US
Practice Address - Phone:262-523-0933
Practice Address - Fax:262-523-1674
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-09
Last Update Date:2010-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI11416-024225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist