Provider Demographics
NPI:1982660551
Name:SCHMITZ, FREDRIK D (MPT OCS SCS)
Entity Type:Individual
Prefix:
First Name:FREDRIK
Middle Name:D
Last Name:SCHMITZ
Suffix:
Gender:M
Credentials:MPT OCS SCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73929 PLAYA VISTA DR
Mailing Address - Street 2:
Mailing Address - City:TWENTYNINE PALMS
Mailing Address - State:CA
Mailing Address - Zip Code:92277-1841
Mailing Address - Country:US
Mailing Address - Phone:760-830-2520
Mailing Address - Fax:
Practice Address - Street 1:NAVAL HOSPITAL ATTN PROFESSIONAL AFFAIRS
Practice Address - Street 2:MAGTFTC MCAGCC BOX 788250
Practice Address - City:TWENTYNINE PALMS
Practice Address - State:CA
Practice Address - Zip Code:92278-8250
Practice Address - Country:US
Practice Address - Phone:760-830-2194
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 19650225100000X, 2251S0007X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Not Answered2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
Not Answered2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic