Provider Demographics
NPI:1104792852
Name:SCHLACHTER, COURTNEY
Entity type:Individual
Prefix:MRS
First Name:COURTNEY
Middle Name:
Last Name:SCHLACHTER
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 1:1410 3RD ST
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48708-6128
Mailing Address - Country:US
Mailing Address - Phone:989-992-2311
Mailing Address - Fax:
Practice Address - Street 1:500 36TH ST
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48708-8337
Practice Address - Country:US
Practice Address - Phone:989-671-7318
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-10
Last Update Date:2025-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization