Provider Demographics
NPI:1619751823
Name:SCHNELLE, SARAH MARIE (MASSAGE THERAPIST)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:MARIE
Last Name:SCHNELLE
Suffix:
Gender:F
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2756 E CAIRO ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65802-2616
Mailing Address - Country:US
Mailing Address - Phone:417-655-6508
Mailing Address - Fax:
Practice Address - Street 1:1950 S GLENSTONE AVE STE F
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65804-2353
Practice Address - Country:US
Practice Address - Phone:417-655-6508
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-21
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2020004495225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist