Provider Demographics
NPI:1942314190
Name:SCHUH, PATRICK R (MPT)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:R
Last Name:SCHUH
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4000 N PROVIDENCE AVE
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54913-8018
Mailing Address - Country:US
Mailing Address - Phone:920-257-2005
Mailing Address - Fax:920-257-2004
Practice Address - Street 1:1901 CROOKS AVE
Practice Address - Street 2:SUITE B
Practice Address - City:KAUKAUNA
Practice Address - State:WI
Practice Address - Zip Code:54130-3200
Practice Address - Country:US
Practice Address - Phone:920-759-9075
Practice Address - Fax:920-759-9076
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2013-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI10384-024225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI40449500Medicaid
MN064S8SCOtherBCBS OF MN
MN064S8SCOtherBCBS OF MN
WI40449500Medicaid
WI001386160Medicare ID - Type Unspecified
WI001186652Medicare ID - Type Unspecified