Provider Demographics
NPI:1760873699
Name:SCHAFFER, KAREN
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:SCHAFFER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1593 S STATE RD
Mailing Address - Street 2:
Mailing Address - City:OMER
Mailing Address - State:MI
Mailing Address - Zip Code:48749-9747
Mailing Address - Country:US
Mailing Address - Phone:989-280-5162
Mailing Address - Fax:
Practice Address - Street 1:3101 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48642-3752
Practice Address - Country:US
Practice Address - Phone:989-280-5162
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-13
Last Update Date:2015-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIL587706225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist