Schroeder, Kelly M

Schroeder, Kelly M is an individual health care provider with primary practice located at 4624 Cedar Lake Dr , West Bend WI 53095-8420. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Schroeder, Kelly M can be contacted via phone (414) 507-9198.

Contact Information

Primary practice address
4624 Cedar Lake Dr West Bend WI 53095-8420
Phone: (414) 507-9198
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 10474 Wisconsin

Profile Details

NPI number 1679775688
LBN Legal business name Schroeder, Kelly M
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 1st, 2007
Last updated Mar 26th, 2024 - about 6 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679775688 NPPES
Wisconsin MEDICAID 36103400

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