Provider Demographics
NPI:1639689722
Name:SCHUMM, ELOISE MAE (PTA)
Entity Type:Individual
Prefix:MRS
First Name:ELOISE
Middle Name:MAE
Last Name:SCHUMM
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:909 NEW JERSEY AVE SE APT 912
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20003-5311
Mailing Address - Country:US
Mailing Address - Phone:541-868-6862
Mailing Address - Fax:
Practice Address - Street 1:7525 CARROLL AVE
Practice Address - Street 2:
Practice Address - City:TAKOMA PARK
Practice Address - State:MD
Practice Address - Zip Code:20912-5715
Practice Address - Country:US
Practice Address - Phone:541-868-6862
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-03
Last Update Date:2017-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant