Basic Information
| Provider Information | |||||||||
| NPI: | 1023204542 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SCHNEIDER | ||||||||
| FirstName: | TERESA | ||||||||
| MiddleName: | ANN | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2310 E ALOE PL | ||||||||
| Address2: | |||||||||
| City: | CHANDLER | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852863106 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4802757525 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3130 E BROADWAY RD | ||||||||
| Address2: | |||||||||
| City: | MESA | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852041740 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4809247777 | ||||||||
| FaxNumber: | 4809245712 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/18/2007 | ||||||||
| LastUpdateDate: | 09/18/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225200000X | 0146A021 | AZ | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant |
No ID Information.