Individual
KELLY M SCHROEDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
4624 CEDAR LAKE DR, WEST BEND, WI 53095-8420
(414) 507-9198
Mailing address
4624 CEDAR LAKE DR, WEST BEND, WI 53095-8420
(414) 507-9198
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
10474
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36103400
—
WI
Enumeration date
06/01/2007
Last updated
03/26/2024
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