Provider Demographics
NPI:1043649684
Name:SCHOENBORN, ANN MARIE (LPTA)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:MARIE
Last Name:SCHOENBORN
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2341 LAKE VIEW AVE # 12
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49696-8079
Mailing Address - Country:US
Mailing Address - Phone:616-427-4456
Mailing Address - Fax:
Practice Address - Street 1:2828 CONCORD ST
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49684-4618
Practice Address - Country:US
Practice Address - Phone:231-941-1200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-04
Last Update Date:2013-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5502002852225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant