Provider Demographics
NPI:1447473913
Name:SCHINDLER, GARY D (DPT, OCS, SCS, ATC)
Entity type:Individual
Prefix:
First Name:GARY
Middle Name:D
Last Name:SCHINDLER
Suffix:
Gender:M
Credentials:DPT, OCS, SCS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1117 S 22ND ST
Mailing Address - Street 2:
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58201-5154
Mailing Address - Country:US
Mailing Address - Phone:701-335-3134
Mailing Address - Fax:
Practice Address - Street 1:2424 32ND AVE S
Practice Address - Street 2:
Practice Address - City:GRAND FORKS
Practice Address - State:ND
Practice Address - Zip Code:58201-6508
Practice Address - Country:US
Practice Address - Phone:701-746-6694
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2018-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI9766024225100000X
ND1736225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI40366000Medicaid
WI40366000Medicaid