Provider Demographics
NPI:1083757959
Name:SCHLICHTENMYER, MARC (ATC, CSCS)
Entity Type:Individual
Prefix:
First Name:MARC
Middle Name:
Last Name:SCHLICHTENMYER
Suffix:
Gender:M
Credentials:ATC, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10500 CITATION DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:BRIGHTON
Mailing Address - State:MI
Mailing Address - Zip Code:48116-6547
Mailing Address - Country:US
Mailing Address - Phone:810-225-9444
Mailing Address - Fax:
Practice Address - Street 1:10500 CITATION DR
Practice Address - Street 2:SUITE 200
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48116-6547
Practice Address - Country:US
Practice Address - Phone:810-225-9444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer