Provider Demographics
NPI:1952938235
Name:SCHULTZ, SONYA J (PT)
Entity Type:Individual
Prefix:
First Name:SONYA
Middle Name:J
Last Name:SCHULTZ
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:851 FERN AVE
Mailing Address - Street 2:
Mailing Address - City:GRAND MARSH
Mailing Address - State:WI
Mailing Address - Zip Code:53936-9681
Mailing Address - Country:US
Mailing Address - Phone:608-584-4496
Mailing Address - Fax:
Practice Address - Street 1:2802 WALTON COMMONS LN
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53718-6785
Practice Address - Country:US
Practice Address - Phone:608-669-2775
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-25
Last Update Date:2020-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4049-24225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist