Basic Information
| Provider Information | |||||||||
| NPI: | 1942369954 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SCHAEFER | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | ARTHUR | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | P.T. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 404 GRIST MILL XING | ||||||||
| Address2: | |||||||||
| City: | SEVERNA PARK | ||||||||
| State: | MD | ||||||||
| PostalCode: | 211462321 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4109871741 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 15825 SHADY GROVE RD | ||||||||
| Address2: | SUITE 50 | ||||||||
| City: | ROCKVILLE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 208504008 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3019870999 | ||||||||
| FaxNumber: | 3109877123 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/06/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 15184 | MD | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.