MEDICARE: MRS. CHRISTINE E SCHMIDT OTRL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	005123	MO

General Provider Information

NPI Number	:	1073650321
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CHRISTINE E SCHMIDT OTRL

Provider Business Mailing Address
First Line	:	647 DEREK DR
Second Line	:
City	:	WENTZVILLE
State	:	MO
Zip	:	63385-6843
Country	:	US
Telephone Number	:	573-480-4030
Fax Number	:

Provider Business Practice Location Address
First Line	:	2127 INNERBELT BUSINESS CENTER DR
Second Line	:	SUITE 107
City	:	SAINT LOUIS
State	:	MO
Zip	:	63114-5700
Country	:	US
Telephone Number	:	573-480-4030
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/30/2007
Last Update Date	:	08/31/2022

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