Provider Demographics
NPI:1689741217
Name:SCHUSTER, EVETT M (COTA)
Entity Type:Individual
Prefix:
First Name:EVETT
Middle Name:M
Last Name:SCHUSTER
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8418 THOMAS BRIDGE LOOP
Mailing Address - Street 2:
Mailing Address - City:PILOT GROVE
Mailing Address - State:MO
Mailing Address - Zip Code:65276-2311
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8418 THOMAS BRIDGE LOOP
Practice Address - Street 2:
Practice Address - City:PILOT GROVE
Practice Address - State:MO
Practice Address - Zip Code:65276-2311
Practice Address - Country:US
Practice Address - Phone:660-834-5331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO004905224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant