Provider Demographics
NPI:1245513050
Name:SCHALLER, BRET (DPT)
Entity type:Individual
Prefix:
First Name:BRET
Middle Name:
Last Name:SCHALLER
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 1:5485 MOORETOWN RD STE E
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23188-2130
Mailing Address - Country:US
Mailing Address - Phone:757-969-5200
Mailing Address - Fax:757-969-5201
Practice Address - Street 1:5485 MOORETOWN RD STE E
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23188-2130
Practice Address - Country:US
Practice Address - Phone:757-969-5200
Practice Address - Fax:757-969-5201
Is Sole Proprietor?:No
Enumeration Date:2011-09-28
Last Update Date:2022-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305207000225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist