Provider Demographics
NPI:1700043437
Name:SCHMITT, JULIE M (PT)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:M
Last Name:SCHMITT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MRS
Other - First Name:JULIE
Other - Middle Name:M
Other - Last Name:URBAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:N546 SCHROETER DR
Mailing Address - Street 2:
Mailing Address - City:RANDOM LAKE
Mailing Address - State:WI
Mailing Address - Zip Code:53075-1272
Mailing Address - Country:US
Mailing Address - Phone:920-994-9700
Mailing Address - Fax:
Practice Address - Street 1:N546 SCHROETER DR
Practice Address - Street 2:
Practice Address - City:RANDOM LAKE
Practice Address - State:WI
Practice Address - Zip Code:53075-1272
Practice Address - Country:US
Practice Address - Phone:920-994-9700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-20
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6092024225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI000080125OtherMEDICARE GROUP PROVIDER