Provider Demographics
NPI:1720534829
Name:SCHADE, KRISTIN (PT, DPT)
Entity Type:Individual
Prefix:MS
First Name:KRISTIN
Middle Name:
Last Name:SCHADE
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 1:15600 N FRANK LLOYD WRIGHT BLVD
Mailing Address - Street 2:# 1176
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-2201
Mailing Address - Country:US
Mailing Address - Phone:801-380-0330
Mailing Address - Fax:623-934-3887
Practice Address - Street 1:4494 W PEORIA AVE
Practice Address - Street 2:SUITE 115B
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85302-2023
Practice Address - Country:US
Practice Address - Phone:623-934-1154
Practice Address - Fax:623-934-3887
Is Sole Proprietor?:No
Enumeration Date:2016-08-29
Last Update Date:2016-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ12521225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist