Provider Demographics
NPI:1487718995
Name:SCHRUM, PAULA BAETEN (PT)
Entity type:Individual
Prefix:MRS
First Name:PAULA
Middle Name:BAETEN
Last Name:SCHRUM
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1539 STANFORD PLACE
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28207-2411
Mailing Address - Country:US
Mailing Address - Phone:704-332-3991
Mailing Address - Fax:
Practice Address - Street 1:1000 BLYTHE BLVD.
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28232
Practice Address - Country:US
Practice Address - Phone:704-446-6852
Practice Address - Fax:704-355-0337
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1288225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist