Healthcare Provider Details

I. General information

NPI: 1427812171
Provider Name (Legal Business Name): DEANNA R SCHULTE PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/12/2024
Last Update Date: 02/12/2024
Certification Date: 02/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2301 W GRAND RIVER AVE
OKEMOS MI
48864-1648
US

IV. Provider business mailing address

2301 W GRAND RIVER AVE
OKEMOS MI
48864-1648
US

V. Phone/Fax

Practice location:
  • Phone: 517-853-6800
  • Fax: 517-853-6801
Mailing address:
  • Phone: 517-853-6800
  • Fax: 517-853-6801

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number5502000384
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: