Provider Demographics
NPI:1700862075
Name:SCHULTE, PHYLLIS A (PT)
Entity Type:Individual
Prefix:
First Name:PHYLLIS
Middle Name:A
Last Name:SCHULTE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4131 CALUMET CIR
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-1843
Mailing Address - Country:US
Mailing Address - Phone:513-398-4282
Mailing Address - Fax:
Practice Address - Street 1:5230 KINGS MILLS RD
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-2319
Practice Address - Country:US
Practice Address - Phone:513-336-7725
Practice Address - Fax:513-336-7825
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT-03310225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist