Provider Demographics
NPI:1396844965
Name:SCHMALTZ, CRAIG F (PT)
Entity Type:Individual
Prefix:MR
First Name:CRAIG
Middle Name:F
Last Name:SCHMALTZ
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 1:8831 QUAIL LN STE 103
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66502-1440
Mailing Address - Country:US
Mailing Address - Phone:785-383-6105
Mailing Address - Fax:
Practice Address - Street 1:8831 QUAIL LN STE 103
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502-1440
Practice Address - Country:US
Practice Address - Phone:785-313-6105
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2024-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ10809225100000X
KS11-02218225100000X
CA10284225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100415050CMedicaid
AZKA2144Medicare PIN