Healthcare Provider Details
I. General information
NPI: 1043646086
Provider Name (Legal Business Name): HEIDI MARIE SCHAUSS PT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 09/23/2013
Last Update Date: 09/23/2013
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
33308 ELECTRIC BLVD
AVON LAKE OH
44012-1216
US
V. Phone/Fax
- Phone: 440-250-8895
- Fax: 440-250-8854
- Phone: 440-933-3858
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2251X0800X |
| Taxonomy | Orthopedic Physical Therapist |
| License Number | 7479 |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: