Basic Information
| Provider Information | |||||||||
| NPI: | 1871562983 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SCHMITZ | ||||||||
| FirstName: | TERRY | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | RKT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 21191 BANFF LN | ||||||||
| Address2: | |||||||||
| City: | HUNTINGTON BEACH | ||||||||
| State: | CA | ||||||||
| PostalCode: | 926466801 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 5901 E 7TH ST | ||||||||
| Address2: | |||||||||
| City: | LONG BEACH | ||||||||
| State: | CA | ||||||||
| PostalCode: | 908225201 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5628265567 | ||||||||
| FaxNumber: | 5628268191 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/14/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 226300000X | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Kinesiotherapist |
No ID Information.