Healthcare Provider Details

I. General information

NPI: 1780841759
Provider Name (Legal Business Name): TINA RUTH SCHAFFNER PT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2008
Last Update Date: 09/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

141 HAMPTON CIR
ROCHESTER HILLS MI
48307-4103
US

IV. Provider business mailing address

2322 COY ST
FERNDALE MI
48220-1122
US

V. Phone/Fax

Practice location:
  • Phone: 248-853-7555
  • Fax:
Mailing address:
  • Phone: 248-398-2520
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number5501011837
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: