Provider Demographics
NPI:1689839490
Name:SHOFF, RACHEL MARIE (PTA)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:MARIE
Last Name:SHOFF
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:MARIE
Other - Last Name:VANDENHEMEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:8518 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:COTTRELLVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48039-3355
Mailing Address - Country:US
Mailing Address - Phone:586-868-9040
Mailing Address - Fax:586-868-9013
Practice Address - Street 1:17900 23 MILE RD
Practice Address - Street 2:
Practice Address - City:MACOMB
Practice Address - State:MI
Practice Address - Zip Code:48044-1161
Practice Address - Country:US
Practice Address - Phone:586-868-9040
Practice Address - Fax:586-868-9013
Is Sole Proprietor?:No
Enumeration Date:2008-07-21
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant