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Individual

ZACHARY SCHMUCKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPT

Contact information

Practice address
12722 TONKEL RD STE 102, FORT WAYNE, IN 46845-8201
(260) 739-0300
Mailing address
53564 STATE ROAD 13, MIDDLEBURY, IN 46540-8931

Taxonomy

Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
05013723A
LICENSE
IN
05
300038798
IN
Enumeration date
05/11/2020
Last updated
06/24/2020
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