Provider Demographics
NPI:1487752564
Name:SCHMIDT, FRED A (PT, MTC)
Entity type:Individual
Prefix:
First Name:FRED
Middle Name:A
Last Name:SCHMIDT
Suffix:
Gender:M
Credentials:PT, MTC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2128 MEAD LN UNIT B
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:CO
Mailing Address - Zip Code:81401-7120
Mailing Address - Country:US
Mailing Address - Phone:970-249-8000
Mailing Address - Fax:
Practice Address - Street 1:2128 MEAD LN UNIT B
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:CO
Practice Address - Zip Code:81401-7120
Practice Address - Country:US
Practice Address - Phone:970-249-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2020-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3147225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist