Provider Demographics
NPI:1922035112
Name:SCHAFER, JEFFREY A (PT)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:A
Last Name:SCHAFER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4213 MILLSBRAE AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45209-1644
Mailing Address - Country:US
Mailing Address - Phone:513-733-3370
Mailing Address - Fax:
Practice Address - Street 1:10400 READING RD
Practice Address - Street 2:SUITE 105
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45241-4816
Practice Address - Country:US
Practice Address - Phone:513-733-3370
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT011411225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist