Provider Demographics
NPI:1225526098
Name:SCHWAB, MICHAEL JOSEPH (OT, MOTR/L)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:JOSEPH
Last Name:SCHWAB
Suffix:
Gender:M
Credentials:OT, MOTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2905 ARROWHEAD DR APT L1
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30909-6035
Mailing Address - Country:US
Mailing Address - Phone:607-592-8731
Mailing Address - Fax:
Practice Address - Street 1:550 EASTGATE DR
Practice Address - Street 2:
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29803-7688
Practice Address - Country:US
Practice Address - Phone:803-643-3694
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-27
Last Update Date:2020-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT007036225X00000X
SCOT.5818225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist