Provider Demographics
NPI:1710750385
Name:SCHLOTTMAN, CASEY CLARISSA (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:CASEY
Middle Name:CLARISSA
Last Name:SCHLOTTMAN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1019 KENNEDY DR
Mailing Address - Street 2:
Mailing Address - City:ST AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32084-8587
Mailing Address - Country:US
Mailing Address - Phone:609-638-3178
Mailing Address - Fax:
Practice Address - Street 1:6807 EMMETT F LOWRY EXPY STE 103
Practice Address - Street 2:
Practice Address - City:TEXAS CITY
Practice Address - State:TX
Practice Address - Zip Code:77591-2543
Practice Address - Country:US
Practice Address - Phone:409-935-2840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-06
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1385508225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist