Basic Information
| Provider Information | |||||||||
| NPI: | 1366198814 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SCHAIBLE | ||||||||
| FirstName: | KRYSTAL | ||||||||
| MiddleName: | C | ||||||||
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| Credential: | OTRL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 300 E PEARL ST APT 1 | ||||||||
| Address2: | |||||||||
| City: | BAY CITY | ||||||||
| State: | MI | ||||||||
| PostalCode: | 487065100 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9899923511 | ||||||||
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| Practice Location | |||||||||
| Address1: | 700 COOPER AVE STE 1100 | ||||||||
| Address2: | |||||||||
| City: | SAGINAW | ||||||||
| State: | MI | ||||||||
| PostalCode: | 486025383 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9895832729 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/23/2022 | ||||||||
| LastUpdateDate: | 02/23/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/23/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 5201012796 | MI | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.