Provider Demographics
NPI:1407595093
Name:SCHAUER, JACOB WILLIAM (DPT)
Entity Type:Individual
Prefix:DR
First Name:JACOB
Middle Name:WILLIAM
Last Name:SCHAUER
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 1:4701 LAKEVIEW LN
Mailing Address - Street 2:
Mailing Address - City:ELM CITY
Mailing Address - State:NC
Mailing Address - Zip Code:27822-8007
Mailing Address - Country:US
Mailing Address - Phone:843-473-5467
Mailing Address - Fax:
Practice Address - Street 1:304 MARCELLA RD STE E
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-2578
Practice Address - Country:US
Practice Address - Phone:757-825-9446
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-01
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2251S0007X
VA2305214339225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist