Provider Demographics
NPI:1760639538
Name:SCHMUCKER, JODY MARIE (PT)
Entity Type:Individual
Prefix:
First Name:JODY
Middle Name:MARIE
Last Name:SCHMUCKER
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 1:4708 GATE POST LN
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:OH
Mailing Address - Zip Code:44240-5609
Mailing Address - Country:US
Mailing Address - Phone:330-673-7719
Mailing Address - Fax:
Practice Address - Street 1:4708 GATE POST LN
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:OH
Practice Address - Zip Code:44240-5609
Practice Address - Country:US
Practice Address - Phone:330-608-2917
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-25
Last Update Date:2017-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT 4837225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist