Provider Demographics
NPI:1073502688
Name:SCHIELER, KIMBERLY GILSTRAP (MS, AT,C)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:GILSTRAP
Last Name:SCHIELER
Suffix:
Gender:F
Credentials:MS, AT,C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 KATHY ST
Mailing Address - Street 2:
Mailing Address - City:TOMAH
Mailing Address - State:WI
Mailing Address - Zip Code:54660-5130
Mailing Address - Country:US
Mailing Address - Phone:608-372-2124
Mailing Address - Fax:
Practice Address - Street 1:901 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:TOMAH
Practice Address - State:WI
Practice Address - Zip Code:54660-1857
Practice Address - Country:US
Practice Address - Phone:608-374-7358
Practice Address - Fax:608-374-7290
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2357312255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer