Provider Demographics
NPI:1407206667
Name:SCHLUETER, GREGGORY T (PT)
Entity Type:Individual
Prefix:
First Name:GREGGORY
Middle Name:T
Last Name:SCHLUETER
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 1:13851 GUILDFORD ST STE B
Mailing Address - Street 2:
Mailing Address - City:WAVERLY
Mailing Address - State:NE
Mailing Address - Zip Code:68462-1453
Mailing Address - Country:US
Mailing Address - Phone:402-786-0476
Mailing Address - Fax:402-786-0479
Practice Address - Street 1:13851 GUILDFORD ST STE B
Practice Address - Street 2:
Practice Address - City:WAVERLY
Practice Address - State:NE
Practice Address - Zip Code:68462-1453
Practice Address - Country:US
Practice Address - Phone:402-786-0476
Practice Address - Fax:402-786-0479
Is Sole Proprietor?:No
Enumeration Date:2016-06-20
Last Update Date:2016-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE3586225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist