Provider Demographics
NPI:1750813416
Name:SCHLEICHER, JERED ROBERT (DPT, PT)
Entity type:Individual
Prefix:DR
First Name:JERED
Middle Name:ROBERT
Last Name:SCHLEICHER
Suffix:
Gender:M
Credentials:DPT, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:143 BEREAN AVE SE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30316-1101
Mailing Address - Country:US
Mailing Address - Phone:440-749-2584
Mailing Address - Fax:
Practice Address - Street 1:9050 PERIDOT PKWY
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-9417
Practice Address - Country:US
Practice Address - Phone:770-474-0540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-31
Last Update Date:2020-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL35125225100000X
OH018191225100000X
CA297506225100000X
GA012792225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist