Provider Demographics
NPI:1093141368
Name:PRECHTEL, STEPHANIE E (MED, ATC)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:E
Last Name:PRECHTEL
Suffix:
Gender:F
Credentials:MED, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:752 MEADOW GLEN AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45309
Mailing Address - Country:US
Mailing Address - Phone:330-256-6522
Mailing Address - Fax:
Practice Address - Street 1:752 MEADOW GLEN AVE
Practice Address - Street 2:
Practice Address - City:BROOKVILLE
Practice Address - State:OH
Practice Address - Zip Code:45309
Practice Address - Country:US
Practice Address - Phone:330-256-6522
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-18
Last Update Date:2013-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAT.0038122255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer