Provider Demographics
NPI:1598796997
Name:SCHASER, SANDRA LYNN (OTR)
Entity Type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:LYNN
Last Name:SCHASER
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6563 W MAIN ST
Mailing Address - Street 2:SUITE: LOWER LEVEL
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49009-4051
Mailing Address - Country:US
Mailing Address - Phone:269-488-3320
Mailing Address - Fax:
Practice Address - Street 1:6563 W MAIN ST
Practice Address - Street 2:SUITE LOWER LEVEL
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49009-4051
Practice Address - Country:US
Practice Address - Phone:268-488-3320
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2015-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201001239225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIP34790002Medicare PIN