MEDICARE: DAWN R SCHULZ MA OTR/L

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	001187	IA

General Provider Information

NPI Number	:	1700048782
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAWN R SCHULZ MA OTR/L

Provider Business Mailing Address
First Line	:	3622 JACKSON AVE
Second Line	:
City	:	SPIRIT LAKE
State	:	IA
Zip	:	51360-4800
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3804 STOVER AVE
Second Line	:
City	:	SPIRIT LAKE
State	:	IA
Zip	:	51360-7677
Country	:	US
Telephone Number	:	712-330-2633
Fax Number	:

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

Provider Enumeration Date	:	06/30/2008
Last Update Date	:	11/18/2019

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