Provider Demographics
NPI:1346541877
Name:SCHANZ, CASEY BRADFORD (PA-C)
Entity Type:Individual
Prefix:
First Name:CASEY
Middle Name:BRADFORD
Last Name:SCHANZ
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2442 WINNE AVE
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601-4921
Mailing Address - Country:US
Mailing Address - Phone:406-447-2823
Mailing Address - Fax:406-447-2825
Practice Address - Street 1:2442 WINNE AVE
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-4921
Practice Address - Country:US
Practice Address - Phone:406-457-4100
Practice Address - Fax:406-457-4110
Is Sole Proprietor?:No
Enumeration Date:2010-11-15
Last Update Date:2020-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTMED-PAC-LIC-50449363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant