Provider Demographics
NPI:1821004755
Name:SCHOTZKO, ANTHONY LEO (PT, DPT)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:LEO
Last Name:SCHOTZKO
Suffix:
Gender:M
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:N5538 LEONHARD LN
Mailing Address - Street 2:
Mailing Address - City:TONY
Mailing Address - State:WI
Mailing Address - Zip Code:54563-9712
Mailing Address - Country:US
Mailing Address - Phone:715-532-0334
Mailing Address - Fax:
Practice Address - Street 1:900 COLLEGE AVE W
Practice Address - Street 2:
Practice Address - City:LADYSMITH
Practice Address - State:WI
Practice Address - Zip Code:54848-2116
Practice Address - Country:US
Practice Address - Phone:715-532-5561
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI10659225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI36116800Medicaid