Provider Demographics
NPI:1770243743
Name:SCHULTZ, ALLISON FAITH (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:FAITH
Last Name:SCHULTZ
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:DR
Other - First Name:ALLISON
Other - Middle Name:FAITH
Other - Last Name:WILLWERSCHEID
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:3870 CLOVER AVE
Mailing Address - Street 2:
Mailing Address - City:VADNAIS HEIGHTS
Mailing Address - State:MN
Mailing Address - Zip Code:55127-7014
Mailing Address - Country:US
Mailing Address - Phone:952-217-0839
Mailing Address - Fax:
Practice Address - Street 1:11855 ULYSSES ST NE STE 20
Practice Address - Street 2:
Practice Address - City:BLAINE
Practice Address - State:MN
Practice Address - Zip Code:55434-3949
Practice Address - Country:US
Practice Address - Phone:763-767-3140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-17
Last Update Date:2022-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN12440225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist