Provider Demographics
NPI:1528653656
Name:SCHMITZ, AMANDA ROSE (CMT)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:ROSE
Last Name:SCHMITZ
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26702 THERESIA TER
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:MN
Mailing Address - Zip Code:56368-8402
Mailing Address - Country:US
Mailing Address - Phone:132-076-1361
Mailing Address - Fax:
Practice Address - Street 1:161 19TH ST S
Practice Address - Street 2:
Practice Address - City:SARTELL
Practice Address - State:MN
Practice Address - Zip Code:56377-4579
Practice Address - Country:US
Practice Address - Phone:320-257-0360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-01
Last Update Date:2021-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist