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General NPI Number Information
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NPI Number | 1295069342
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Entity Type | Individual
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Provider Name | THERESA SCHMOTZER B.S. OT
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Gender | Female
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Dates
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Enumeration Date | 09/22/2009
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Last Update Date | 01/11/2013
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Provider Practice Location Address
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Address Line | 2653 N 143RD DR
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City | GOODYEAR
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State | AZ
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Zip | 85395-1459
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Country | US
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Telephone | 808-497-1292
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Fax | 623-594-0469
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Provider Business Mailing Address
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Address Line | 2653 N 143RD DR
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City | GOODYEAR
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State | AZ
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Zip | 85395-1459
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Country | US
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Telephone | 808-497-1292
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Fax | 623-594-0469
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171W00000X
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Taxonomy Name | Contractor
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License Number | 4289
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License Number State | AZ
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