Provider Demographics
NPI:1720568900
Name:SCHREIBER, CASSIDY (ATC)
Entity Type:Individual
Prefix:
First Name:CASSIDY
Middle Name:
Last Name:SCHREIBER
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 E 2200 N APT B108
Mailing Address - Street 2:
Mailing Address - City:NORTH LOGAN
Mailing Address - State:UT
Mailing Address - Zip Code:84341-4714
Mailing Address - Country:US
Mailing Address - Phone:360-490-6436
Mailing Address - Fax:
Practice Address - Street 1:211 MONTANA HALL
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59717
Practice Address - Country:US
Practice Address - Phone:406-994-0211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-17
Last Update Date:2020-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer