Provider Demographics
NPI:1992011365
Name:SCHMIDT, BRIAN KEITH (CPTA)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:KEITH
Last Name:SCHMIDT
Suffix:
Gender:M
Credentials:CPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 ELMHURST BLVD
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-7404
Mailing Address - Country:US
Mailing Address - Phone:785-825-2911
Mailing Address - Fax:785-825-2912
Practice Address - Street 1:1000 ELMHURST BLVD
Practice Address - Street 2:
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-7404
Practice Address - Country:US
Practice Address - Phone:785-825-2911
Practice Address - Fax:785-825-2912
Is Sole Proprietor?:No
Enumeration Date:2010-08-24
Last Update Date:2010-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS14-01296225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant