Provider Demographics
NPI:1619970324
Name:SCHROEDER, GREGORY A (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:A
Last Name:SCHROEDER
Suffix:
Gender:M
Credentials:PHYSICAL THERAPIST
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Mailing Address - Street 1:1414 S OAK AVE
Mailing Address - Street 2:STE 2
Mailing Address - City:OWATONNA
Mailing Address - State:MN
Mailing Address - Zip Code:55060-3957
Mailing Address - Country:US
Mailing Address - Phone:507-451-8254
Mailing Address - Fax:507-451-7324
Practice Address - Street 1:1414 S OAK AVE
Practice Address - Street 2:STE 2
Practice Address - City:OWATONNA
Practice Address - State:MN
Practice Address - Zip Code:55060-3957
Practice Address - Country:US
Practice Address - Phone:507-451-8254
Practice Address - Fax:507-451-7324
Is Sole Proprietor?:No
Enumeration Date:2005-05-27
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN6296225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist