Healthcare Provider Details

I. General information

NPI: 1598186314
Provider Name (Legal Business Name): ANNA LOWTHER SCHOENBORN MS OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS ANNA LOWTHER MOORE

II. Dates (important events)

Enumeration Date: 12/20/2013
Last Update Date: 12/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 CONRAN DR
COOPERSVILLE MI
49404-1366
US

IV. Provider business mailing address

1868 ROOSEVELT ST
COOPERSVILLE MI
49404-9652
US

V. Phone/Fax

Practice location:
  • Phone: 616-997-6172
  • Fax: 616-965-2475
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number5201008503
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: