Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225XE0001X | Environmental Modification | OT.0003624 | CO |
Y | 225XG0600X | Occupational Therapist - Gerontology | OT.0003624 | CO |
NPI | 1700340585 |
---|---|
Provider Name | Karl Martin Schwartz |
First Address | Glenwood Springs, CO 81601-9545 |
Second Address | Glenwood Springs, CO 81601-9545 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/01/2019 |
Last Update Date | 25/01/2019 |