Provider Demographics
NPI:1023340130
Name:SCHROER, GRETCHEN RENAE (DPT)
Entity type:Individual
Prefix:MS
First Name:GRETCHEN
Middle Name:RENAE
Last Name:SCHROER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:GRETCHEN
Other - Middle Name:RENAE
Other - Last Name:SPIES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:3605 UNIVERSITY DR STE 2
Mailing Address - Street 2:
Mailing Address - City:MUSCATINE
Mailing Address - State:IA
Mailing Address - Zip Code:52761-9607
Mailing Address - Country:US
Mailing Address - Phone:563-263-2639
Mailing Address - Fax:563-263-2691
Practice Address - Street 1:850 43RD AVE STE 100
Practice Address - Street 2:
Practice Address - City:MOLINE
Practice Address - State:IL
Practice Address - Zip Code:61265-8401
Practice Address - Country:US
Practice Address - Phone:309-743-2070
Practice Address - Fax:309-743-2073
Is Sole Proprietor?:No
Enumeration Date:2010-02-01
Last Update Date:2014-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA004656225100000X
IL070-018208225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA004656OtherIOWA PT LICENSE
IA004656OtherIOWA PT LICENSE