Provider Demographics
NPI:1154014777
Name:SCHUCH, JONAH MATTHEW (DPT, PT)
Entity type:Individual
Prefix:
First Name:JONAH
Middle Name:MATTHEW
Last Name:SCHUCH
Suffix:
Gender:M
Credentials:DPT, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:514 N AMERICAS WAY, PMB 19017
Mailing Address - Street 2:
Mailing Address - City:BOX ELDER
Mailing Address - State:SD
Mailing Address - Zip Code:57719
Mailing Address - Country:US
Mailing Address - Phone:760-275-5595
Mailing Address - Fax:
Practice Address - Street 1:1000 N ARGONNE RD
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99212-2600
Practice Address - Country:US
Practice Address - Phone:509-534-4300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-30
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD2421225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist