Provider Demographics
NPI:1003208802
Name:TSCHANZ, ANN MARIE CLAIRE
Entity Type:Individual
Prefix:
First Name:ANN MARIE
Middle Name:CLAIRE
Last Name:TSCHANZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46195 N GREENS REST DR
Mailing Address - Street 2:
Mailing Address - City:GREAT MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:20634-3065
Mailing Address - Country:US
Mailing Address - Phone:850-776-2841
Mailing Address - Fax:
Practice Address - Street 1:22630 GREGORY DR
Practice Address - Street 2:
Practice Address - City:LEONARDTOWN
Practice Address - State:MD
Practice Address - Zip Code:20650-4723
Practice Address - Country:US
Practice Address - Phone:850-776-2841
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-03
Last Update Date:2019-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA42258225100000X
MD24343225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist