Provider Demographics
NPI:1356850507
Name:SCHROEDER, PATRICK (DPT, PT)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:
Last Name:SCHROEDER
Suffix:
Gender:M
Credentials:DPT, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NORTON
Mailing Address - State:MA
Mailing Address - Zip Code:02766-2436
Mailing Address - Country:US
Mailing Address - Phone:574-440-9998
Mailing Address - Fax:508-285-4483
Practice Address - Street 1:26 S MAIN ST
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:MA
Practice Address - Zip Code:02368-4821
Practice Address - Country:US
Practice Address - Phone:781-961-9200
Practice Address - Fax:781-961-6599
Is Sole Proprietor?:No
Enumeration Date:2017-09-20
Last Update Date:2018-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA23299225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA23299OtherPT LICENSE