Provider Demographics
NPI:1255705083
Name:SCHLICHTE, COURTNEY JACINDA (PT, DPT)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:JACINDA
Last Name:SCHLICHTE
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:WHITING
Mailing Address - State:IA
Mailing Address - Zip Code:51063-1016
Mailing Address - Country:US
Mailing Address - Phone:785-766-4442
Mailing Address - Fax:
Practice Address - Street 1:315 W 5TH ST
Practice Address - Street 2:
Practice Address - City:STORM LAKE
Practice Address - State:IA
Practice Address - Zip Code:50588-1743
Practice Address - Country:US
Practice Address - Phone:785-766-4442
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-17
Last Update Date:2019-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA078316225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist