Provider Demographics
NPI:1457537045
Name:SCHMIDT, JEANNETTE GOULD (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:MRS
First Name:JEANNETTE
Middle Name:GOULD
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:MS
Other - First Name:JEANNETTE
Other - Middle Name:
Other - Last Name:GOULD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHYSICAL THERAPIST
Mailing Address - Street 1:190 SEACOAST SHORES BLVD
Mailing Address - Street 2:
Mailing Address - City:EAST FALMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02536-6477
Mailing Address - Country:US
Mailing Address - Phone:508-548-7440
Mailing Address - Fax:
Practice Address - Street 1:83 PEARL ST
Practice Address - Street 2:
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601-3922
Practice Address - Country:US
Practice Address - Phone:508-775-6240
Practice Address - Fax:508-790-4298
Is Sole Proprietor?:No
Enumeration Date:2008-01-14
Last Update Date:2008-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA73022251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics