Provider Demographics
NPI:1265519136
Name:SCHIFF, RANDALL WILBERT (PT/ ATC)
Entity type:Individual
Prefix:
First Name:RANDALL
Middle Name:WILBERT
Last Name:SCHIFF
Suffix:
Gender:M
Credentials:PT/ ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:965 W MORGAN RD
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON
Mailing Address - State:OH
Mailing Address - Zip Code:44047-8131
Mailing Address - Country:US
Mailing Address - Phone:440-992-8185
Mailing Address - Fax:
Practice Address - Street 1:2241 LAKE AVE
Practice Address - Street 2:
Practice Address - City:ASHTABULA
Practice Address - State:OH
Practice Address - Zip Code:44004-3437
Practice Address - Country:US
Practice Address - Phone:440-998-0033
Practice Address - Fax:440-998-0091
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH41182251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic