Healthcare Provider Details

I. General information

NPI: 1710938691
Provider Name (Legal Business Name): JONATHAN HARRY SCHAUSS PT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/15/2006
Last Update Date: 12/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

671 COLUMBIA RD SUITE 2
WESTLAKE OH
44145-1477
US

IV. Provider business mailing address

671 COLUMBIA RD SUITE 2
WESTLAKE OH
44145-1477
US

V. Phone/Fax

Practice location:
  • Phone: 216-409-3979
  • Fax: 440-933-3858
Mailing address:
  • Phone: 216-409-3979
  • Fax: 440-933-3858

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT6302
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: