Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 05011848A | IN |
NPI | 1073049383 |
---|---|
Provider Name | Nichole Schmidt |
First Address | Lafayette, IN 47904-2163 |
Second Address | Lafayette, IN 47904-2163 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/05/2017 |
Last Update Date | 05/05/2017 |