Basic Information
| Provider Information | |||||||||
| NPI: | 1265754352 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SCHURMAN | ||||||||
| FirstName: | AMBER | ||||||||
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| Credential: | OTR | ||||||||
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| Mailing Information | |||||||||
| Address1: | 612 E OAK ST | ||||||||
| Address2: | |||||||||
| City: | GLENWOOD CITY | ||||||||
| State: | WI | ||||||||
| PostalCode: | 540138520 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7152654325 | ||||||||
| FaxNumber: | 7152654375 | ||||||||
| Practice Location | |||||||||
| Address1: | 612 E OAK ST | ||||||||
| Address2: | |||||||||
| City: | GLENWOOD CITY | ||||||||
| State: | WI | ||||||||
| PostalCode: | 540138520 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7152654325 | ||||||||
| FaxNumber: | 7152654375 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/17/2010 | ||||||||
| LastUpdateDate: | 02/17/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 3184-26 | WI | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.