Provider Demographics
NPI:1740538149
Name:SCHULZE, ANDREW M (PT)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:M
Last Name:SCHULZE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:830 FALLS CREEK DR
Mailing Address - Street 2:
Mailing Address - City:VANDALIA
Mailing Address - State:OH
Mailing Address - Zip Code:45377-8600
Mailing Address - Country:US
Mailing Address - Phone:937-890-9235
Mailing Address - Fax:
Practice Address - Street 1:515 E MAIN ST STE D
Practice Address - Street 2:
Practice Address - City:ANNA
Practice Address - State:OH
Practice Address - Zip Code:45302-9440
Practice Address - Country:US
Practice Address - Phone:937-639-2063
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-16
Last Update Date:2014-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305207360225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist