Provider Demographics
NPI:1043646086
Name:SCHAUSS, HEIDI MARIE (PT)
Entity Type:Individual
Prefix:MRS
First Name:HEIDI
Middle Name:MARIE
Last Name:SCHAUSS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:HEIDI
Other - Middle Name:MARIE
Other - Last Name:MUNICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:33308 ELECTRIC BLVD
Mailing Address - Street 2:
Mailing Address - City:AVON LAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44012-1216
Mailing Address - Country:US
Mailing Address - Phone:440-933-3858
Mailing Address - Fax:
Practice Address - Street 1:671 COLUMBIA RD
Practice Address - Street 2:SUITE 2
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-1477
Practice Address - Country:US
Practice Address - Phone:440-250-8895
Practice Address - Fax:440-250-8854
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-23
Last Update Date:2013-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH74792251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
H094130OtherGROUP PROVIDER NUMBER