Provider Demographics
NPI:1003341827
Name:DANGEL, ZACHARY ROBERT (LAT, ATC)
Entity Type:Individual
Prefix:
First Name:ZACHARY
Middle Name:ROBERT
Last Name:DANGEL
Suffix:
Gender:M
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3542 SMITHFIELD LN
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45239-3828
Mailing Address - Country:US
Mailing Address - Phone:513-543-4126
Mailing Address - Fax:
Practice Address - Street 1:3542 SMITHFIELD LN
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45239-3828
Practice Address - Country:US
Practice Address - Phone:513-543-4126
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-30
Last Update Date:2017-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN36002656A2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer