Provider Demographics
NPI:1972003283
Name:CARRIE SCHUESSLER DBA NEW PATH PHYSICAL THERAPY
Entity Type:Organization
Organization Name:CARRIE SCHUESSLER DBA NEW PATH PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PT
Authorized Official - Prefix:
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHUESSLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-380-0337
Mailing Address - Street 1:3923 S BOX CANYON TRL
Mailing Address - Street 2:
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86005-6978
Mailing Address - Country:US
Mailing Address - Phone:928-380-0337
Mailing Address - Fax:928-438-0607
Practice Address - Street 1:2501 N 4TH ST STE 24
Practice Address - Street 2:
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86004-3724
Practice Address - Country:US
Practice Address - Phone:928-380-0337
Practice Address - Fax:928-438-0607
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-14
Last Update Date:2018-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5565261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy