Provider Demographics
NPI:1861619686
Name:SCHULZ, JENNIFER LYTLE (LPTA)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LYTLE
Last Name:SCHULZ
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 NEIGHBOR LN
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29072-7960
Mailing Address - Country:US
Mailing Address - Phone:803-358-0928
Mailing Address - Fax:
Practice Address - Street 1:820 NEIGHBOR LN
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29072-7960
Practice Address - Country:US
Practice Address - Phone:803-358-0928
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1628225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant