Basic Information
| Provider Information | |||||||||
| NPI: | 1629029632 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SCHWEISS | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | ROMAN | ||||||||
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| Credential: | OT/R | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7541 9TH ST N | ||||||||
| Address2: | |||||||||
| City: | OAKDALE | ||||||||
| State: | MN | ||||||||
| PostalCode: | 551286626 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6517474328 | ||||||||
| FaxNumber: | 6517482892 | ||||||||
| Practice Location | |||||||||
| Address1: | 1700 TOWER DR W | ||||||||
| Address2: | |||||||||
| City: | STILLWATER | ||||||||
| State: | MN | ||||||||
| PostalCode: | 550827511 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6514398540 | ||||||||
| FaxNumber: | 6514397173 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/15/2006 | ||||||||
| LastUpdateDate: | 07/02/2009 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 102432 | MN | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.