MEDICARE: SCOTT STASZAK II

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	5201009073	MI

General Provider Information

NPI Number	:	1306244736
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SCOTT STASZAK II

Provider Business Mailing Address
First Line	:	500 HANCOCK ST
Second Line	:
City	:	SAGINAW
State	:	MI
Zip	:	48602-4224
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3727 WILDER RD STE A&B
Second Line	:
City	:	BAY CITY
State	:	MI
Zip	:	48706-2367
Country	:	US
Telephone Number	:	989-980-9747
Fax Number	:

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

Provider Enumeration Date	:	12/17/2014
Last Update Date	:	08/07/2019

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Directions to “ SCOTT STASZAK II ” Practice Location

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