Provider Demographics
NPI:1760022537
Name:SCHNETZER, COLTON
Entity Type:Individual
Prefix:
First Name:COLTON
Middle Name:
Last Name:SCHNETZER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5627 NW 86TH ST
Mailing Address - Street 2:STE 200
Mailing Address - City:JOHNSTON
Mailing Address - State:IA
Mailing Address - Zip Code:50131-1738
Mailing Address - Country:US
Mailing Address - Phone:630-575-1980
Mailing Address - Fax:
Practice Address - Street 1:3815 STANGE RD
Practice Address - Street 2:
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50010-3914
Practice Address - Country:US
Practice Address - Phone:515-956-4970
Practice Address - Fax:515-956-4988
Is Sole Proprietor?:No
Enumeration Date:2020-01-09
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist