Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 2533 | AZ |
NPI | 1154688729 |
---|---|
Provider Name | Mr. Dennis Troy Schmahl |
First Address | Tucson, AZ 85712-1535 |
Second Address | Tucson, AZ 85712-1535 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2012 |
Last Update Date | 19/04/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
P31760 | (02) | AZ |