Provider Demographics
NPI:1639525082
Name:SCHANTZ, CATHERINE (MED, ATC, LAT)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:SCHANTZ
Suffix:
Gender:F
Credentials:MED, ATC, LAT
Other - Prefix:
Other - First Name:CASSIE
Other - Middle Name:
Other - Last Name:SCHANTZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1300 S COUNTRY CLUB RD
Mailing Address - Street 2:
Mailing Address - City:EL RENO
Mailing Address - State:OK
Mailing Address - Zip Code:73036-5304
Mailing Address - Country:US
Mailing Address - Phone:422-405-1291
Mailing Address - Fax:
Practice Address - Street 1:1300 S COUNTRY CLUB RD
Practice Address - Street 2:
Practice Address - City:EL RENO
Practice Address - State:OK
Practice Address - Zip Code:73036-5304
Practice Address - Country:US
Practice Address - Phone:422-405-1291
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-04
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3133225200000X
2255A2300X
OK8982255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer