Provider Demographics
NPI:1952826984
Name:SCHMIDT, STEVEN (DPT)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:SCHMIDT
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 1:14555 W NATIONAL AVE STE 195
Mailing Address - Street 2:
Mailing Address - City:NEW BERLIN
Mailing Address - State:WI
Mailing Address - Zip Code:53151-4484
Mailing Address - Country:US
Mailing Address - Phone:262-827-2929
Mailing Address - Fax:
Practice Address - Street 1:14555 W NATIONAL AVE STE 195
Practice Address - Street 2:
Practice Address - City:NEW BERLIN
Practice Address - State:WI
Practice Address - Zip Code:53151-4484
Practice Address - Country:US
Practice Address - Phone:262-827-2929
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-10
Last Update Date:2017-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI13222-24225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist