Provider Demographics
NPI:1891116349
Name:SCHOWALTER, ANN MARIE FRIEDA (PT)
Entity Type:Individual
Prefix:
First Name:ANN MARIE
Middle Name:FRIEDA
Last Name:SCHOWALTER
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 1:10 S 4TH ST
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53704-5219
Mailing Address - Country:US
Mailing Address - Phone:608-334-5476
Mailing Address - Fax:
Practice Address - Street 1:10 S 4TH ST
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53704-5219
Practice Address - Country:US
Practice Address - Phone:608-334-5476
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-31
Last Update Date:2013-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3239-024225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist