Provider Demographics
NPI:1205973724
Name:SCHOCK, KERI LYNN (PT)
Entity type:Individual
Prefix:MRS
First Name:KERI
Middle Name:LYNN
Last Name:SCHOCK
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32812 SAN JOSE CT
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92592-7116
Mailing Address - Country:US
Mailing Address - Phone:810-287-5268
Mailing Address - Fax:
Practice Address - Street 1:32812 SAN JOSE CT
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92592-7116
Practice Address - Country:US
Practice Address - Phone:810-287-5268
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2008-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA333992251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic