Provider Demographics
NPI:1376850040
Name:SCHUMACHER, HOLLY (ATC, LAT)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:
Last Name:SCHUMACHER
Suffix:
Gender:F
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:669 FRANKLIN CT
Mailing Address - Street 2:APT H
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47803-4204
Mailing Address - Country:US
Mailing Address - Phone:309-226-7465
Mailing Address - Fax:
Practice Address - Street 1:669 FRANKLIN CT
Practice Address - Street 2:APT H
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47803-4204
Practice Address - Country:US
Practice Address - Phone:309-226-7465
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-01
Last Update Date:2010-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN36001699A2255A2300X
IL096.0029512255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer