Provider Demographics
NPI:1588210694
Name:SCHNEIDER, ELIZABETH ANNA (PT, DPT)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ANNA
Last Name:SCHNEIDER
Suffix:
Gender:F
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 1:68 CHARLOTTE DR SW
Mailing Address - Street 2:
Mailing Address - City:MABLETON
Mailing Address - State:GA
Mailing Address - Zip Code:30126-1806
Mailing Address - Country:US
Mailing Address - Phone:678-520-6809
Mailing Address - Fax:
Practice Address - Street 1:2745 SANDY PLAINS RD STE 154
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30066-4396
Practice Address - Country:US
Practice Address - Phone:770-783-1171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-14
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT014166225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist