Provider Demographics
NPI:1568539567
Name:SCHULTE, OSA (PHD, PT, GCFP/AT)
Entity Type:Individual
Prefix:MRS
First Name:OSA
Middle Name:
Last Name:SCHULTE
Suffix:
Gender:F
Credentials:PHD, PT, GCFP/AT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5386 BRONCO DR
Mailing Address - Street 2:
Mailing Address - City:CLARKSTON
Mailing Address - State:MI
Mailing Address - Zip Code:48346-2608
Mailing Address - Country:US
Mailing Address - Phone:586-323-6013
Mailing Address - Fax:586-580-0070
Practice Address - Street 1:5386 BRONCO DR
Practice Address - Street 2:
Practice Address - City:CLARKSTON
Practice Address - State:MI
Practice Address - Zip Code:48346-2608
Practice Address - Country:US
Practice Address - Phone:586-484-0549
Practice Address - Fax:248-922-1951
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2018-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501000956225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0N85080001Medicare ID - Type UnspecifiedMEDICARE BER