Healthcare Provider Details

I. General information

NPI: 1558769604
Provider Name (Legal Business Name): WOLFGANG SCHABER OTR/L
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/05/2014
Last Update Date: 12/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

421 KENDALL RD
KNOXVILLE TN
37919-6804
US

IV. Provider business mailing address

421 KENDALL RD
KNOXVILLE TN
37919-6804
US

V. Phone/Fax

Practice location:
  • Phone: 865-237-6038
  • Fax: 855-232-8604
Mailing address:
  • Phone: 865-237-6038
  • Fax: 855-232-8604

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number5001
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: