Provider Demographics
NPI:1194761650
Name:SCHRAG, MARY H (PT, OCS)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:H
Last Name:SCHRAG
Suffix:
Gender:F
Credentials:PT, OCS
Other - Prefix:MRS
Other - First Name:MARY
Other - Middle Name:H
Other - Last Name:SHEID
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, OCS
Mailing Address - Street 1:1480 8TH ST
Mailing Address - Street 2:
Mailing Address - City:WEST PLAINS
Mailing Address - State:MO
Mailing Address - Zip Code:65775-2010
Mailing Address - Country:US
Mailing Address - Phone:417-256-5669
Mailing Address - Fax:
Practice Address - Street 1:1480 W 8TH ST
Practice Address - Street 2:
Practice Address - City:WEST PLAINS
Practice Address - State:MO
Practice Address - Zip Code:65775-2010
Practice Address - Country:US
Practice Address - Phone:417-256-5669
Practice Address - Fax:417-256-5699
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-22
Last Update Date:2019-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR656225100000X
MO01442225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
973358OtherUNITED HEALTH CARE
336556OtherHEALTHLINK
MO483369310Medicaid
MO48369302Medicaid