Provider Demographics
NPI:1104810837
Name:SCHOEN, MICHAEL J (PT)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:J
Last Name:SCHOEN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3039 PLUMBROOK DR
Mailing Address - Street 2:
Mailing Address - City:MAUMEE
Mailing Address - State:OH
Mailing Address - Zip Code:43537-9662
Mailing Address - Country:US
Mailing Address - Phone:419-474-2545
Mailing Address - Fax:419-474-2505
Practice Address - Street 1:3039 PLUMBROOK DR
Practice Address - Street 2:
Practice Address - City:MAUMEE
Practice Address - State:OH
Practice Address - Zip Code:43537-9662
Practice Address - Country:US
Practice Address - Phone:419-474-2545
Practice Address - Fax:419-474-2505
Is Sole Proprietor?:No
Enumeration Date:2005-09-08
Last Update Date:2007-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT.001261225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH4031161Medicare PIN