Basic Information
Provider Information
NPI: 1457990012
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SCHMEHL
FirstName: GREGORY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 475 ALLENDALE RD STE 206
Address2:  
City: KING OF PRUSSIA
State: PA
PostalCode: 194061495
CountryCode: US
TelephoneNumber: 6102700370
FaxNumber: 6102700374
Practice Location
Address1: 528 KIMBERTON RD
Address2:  
City: PHOENIXVILLE
State: PA
PostalCode: 194604737
CountryCode: US
TelephoneNumber: 6109336232
FaxNumber: 6109336234
Other Information
ProviderEnumerationDate: 12/31/2019
LastUpdateDate: 12/31/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
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AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 12/31/2019

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2251X0800XPT027065PAY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic

No ID Information.


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