Provider Demographics
NPI:1467106880
Name:SCHUMANN, EDWARD BLAKE (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:BLAKE
Last Name:SCHUMANN
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10864 ROSEBRIAR DR
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:KY
Mailing Address - Zip Code:41091-8011
Mailing Address - Country:US
Mailing Address - Phone:859-663-6342
Mailing Address - Fax:
Practice Address - Street 1:68 CAVALIER BLVD STE 1700
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-1645
Practice Address - Country:US
Practice Address - Phone:859-283-0707
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-04
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY008477225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist