Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 2018003470 | MO |
NPI | 1003315268 |
---|---|
Provider Name | Nicholas Joseph Schwent |
First Address | Saint Charles, MO 63301-2548 |
Second Address | Wentzville, MO 63385-3499 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/02/2018 |
Last Update Date | 02/02/2018 |