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Individual

MRS. KASSANDRA SCHROEDER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
2400 FARMINGTON AVE, FARMINGTON, NM 87401-4509
(505) 326-0064
(505) 327-3995
Mailing address
718 N DUSTIN AVE, FARMINGTON, NM 87401-6102
(253) 830-4592

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A-1158
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
08171050
NM
Enumeration date
03/14/2017
Last updated
03/14/2017
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