Most Relevant Information
Provider Data
| NPI Number: | 1003467655 |
| Provider Name: | TIA SCHRADER DPT |
| Entity Type: | Individual |
| Taxonomy Code: | 225100000X |
| Specialty: | Physical Therapist |
| License Number: | 05012913A |
Most Important Dates
| Enumeration Date: | 09/25/2019 |
| Last Updated: | 09/25/2019 |
Provider Practice Location
4251 LAHMEYER RD
FORT WAYNE
IN
468155676
Practice Location Phone/Fax
| Phone: | 2604324700 |
| Fax: |
Provider Mailing Location
4251 LAHMEYER RD
FORT WAYNE
IN
468155676
Provider Mailing Phone/Fax
| Phone: | 2604324700 |
| Fax: |