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Individual

KEENAN RUSSELL SCHUMM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
COTA

Contact information

Practice address
3611 N WARE RD., MCALLEN, TX 78501
(956) 688-6969
Mailing address
13016 MAIN ST., LEO, IN 46765-9639
(260) 804-2161

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
210627
TX
224Z00000X
Occupational Therapy Assistant
32001772A
IN
224Z00000X
Occupational Therapy Assistant
OC60138335
WA

Other

Enumeration date
11/11/2010
Last updated
11/11/2010
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