Provider Demographics
NPI:1427350198
Name:SCHWALM, DEEANNE KRISTIN (PT, DPT)
Entity type:Individual
Prefix:MISS
First Name:DEEANNE
Middle Name:KRISTIN
Last Name:SCHWALM
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:MISS
Other - First Name:DEEANNE
Other - Middle Name:KRISTIN
Other - Last Name:SILVAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:1161 EAST CLARK ROAD
Mailing Address - Street 2:SUITE 156
Mailing Address - City:DEWITT
Mailing Address - State:MI
Mailing Address - Zip Code:48820
Mailing Address - Country:US
Mailing Address - Phone:517-668-0000
Mailing Address - Fax:517-668-0017
Practice Address - Street 1:1161 E CLARK RD STE 156
Practice Address - Street 2:
Practice Address - City:DEWITT
Practice Address - State:MI
Practice Address - Zip Code:48820-8312
Practice Address - Country:US
Practice Address - Phone:517-668-0000
Practice Address - Fax:517-668-0017
Is Sole Proprietor?:No
Enumeration Date:2010-12-01
Last Update Date:2015-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501015441225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist