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General NPI Number Information
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NPI Number | 1891986659
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Entity Type | Individual
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Provider Name | MR. FORREST A SCHWANDER
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Gender | Male
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Dates
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Enumeration Date | 08/07/2007
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Last Update Date | 08/07/2007
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Provider Practice Location Address
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Address Line | 1312 OAKLAND DR
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City | KALAMAZOO
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State | MI
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Zip | 49008-1205
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Country | US
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Telephone | 269-337-3045
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Fax |
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Provider Business Mailing Address
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Address Line | 48834 HICKORY LN
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City | MATTAWAN
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State | MI
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Zip | 49071-8792
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Country | US
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Telephone | 269-668-4489
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Fax |
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 5201002166
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License Number State | MI
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