Provider Demographics
NPI:1265748305
Name:SCHAAF, GERI LYNN (PT)
Entity type:Individual
Prefix:
First Name:GERI
Middle Name:LYNN
Last Name:SCHAAF
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1181 TALACHE RD
Mailing Address - Street 2:
Mailing Address - City:SAGLE
Mailing Address - State:ID
Mailing Address - Zip Code:83860-9224
Mailing Address - Country:US
Mailing Address - Phone:208-263-3454
Mailing Address - Fax:
Practice Address - Street 1:30336 HIGHWAY 200 STE B
Practice Address - Street 2:
Practice Address - City:PONDERAY
Practice Address - State:ID
Practice Address - Zip Code:83852-9775
Practice Address - Country:US
Practice Address - Phone:208-265-8333
Practice Address - Fax:208-263-1394
Is Sole Proprietor?:No
Enumeration Date:2010-08-26
Last Update Date:2010-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDPT-455174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist