Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 2305203921 | VA |
N | 2251X0800X | Physical Therapist - Orthopedic | 2305203921 | VA |
NPI | 1083722748 |
---|---|
Provider Name | Andrea Schott |
First Address | Virginia Beach, VA 23462-1832 |
Second Address | Virginia Beach, VA 23454-2440 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/08/2006 |
Last Update Date | 30/07/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
P77144 | (02) | VA |