Provider Demographics
NPI:1922882695
Name:SCHAEFER, BRETT RYAN (DPT)
Entity Type:Individual
Prefix:
First Name:BRETT
Middle Name:RYAN
Last Name:SCHAEFER
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:928 DIAMOND SPRINGS RD STE 103
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23455-6601
Mailing Address - Country:US
Mailing Address - Phone:757-395-1975
Mailing Address - Fax:
Practice Address - Street 1:6201 E VIRGINIA BEACH BLVD STE 110
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-2807
Practice Address - Country:US
Practice Address - Phone:757-261-0820
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-23
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305215856225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist