Provider Demographics
NPI:1275747602
Name:SCHROEDER, DAVID DANIEL (OTRL)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:DANIEL
Last Name:SCHROEDER
Suffix:
Gender:M
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29774 RIVERVIEW RD
Mailing Address - Street 2:
Mailing Address - City:FERGUS FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:56537-7937
Mailing Address - Country:US
Mailing Address - Phone:218-770-6781
Mailing Address - Fax:
Practice Address - Street 1:29774 RIVERVIEW RD
Practice Address - Street 2:
Practice Address - City:FERGUS FALLS
Practice Address - State:MN
Practice Address - Zip Code:56537-7937
Practice Address - Country:US
Practice Address - Phone:218-770-6781
Practice Address - Fax:218-736-4392
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FM102130225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist