Provider Demographics
NPI:1346915170
Name:SCHALL, ZACHARY JONAS (DPT)
Entity Type:Individual
Prefix:
First Name:ZACHARY
Middle Name:JONAS
Last Name:SCHALL
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25324 SUNSET AVE
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:MD
Mailing Address - Zip Code:21639
Mailing Address - Country:US
Mailing Address - Phone:410-479-0470
Mailing Address - Fax:410-479-0526
Practice Address - Street 1:103 S 7TH ST
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:MD
Practice Address - Zip Code:21629-1318
Practice Address - Country:US
Practice Address - Phone:410-479-0470
Practice Address - Fax:410-479-0526
Is Sole Proprietor?:No
Enumeration Date:2021-08-13
Last Update Date:2021-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD28570225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist