Provider Demographics
NPI:1831329382
Name:SCHMIDT, DEANNE MARCIA (PTA)
Entity type:Individual
Prefix:
First Name:DEANNE
Middle Name:MARCIA
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:DEANNE
Other - Middle Name:MARCIA
Other - Last Name:VANDERHAEGHEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:1959 DUBONNET CT
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:CO
Mailing Address - Zip Code:81401-6435
Mailing Address - Country:US
Mailing Address - Phone:432-288-1198
Mailing Address - Fax:
Practice Address - Street 1:2050 S MAIN ST
Practice Address - Street 2:
Practice Address - City:DELTA
Practice Address - State:CO
Practice Address - Zip Code:81416-2407
Practice Address - Country:US
Practice Address - Phone:970-874-9773
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-18
Last Update Date:2009-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant