Provider Demographics
NPI:1124564729
Name:RETTIG, MEGAN (OTR/L)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:RETTIG
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:
Other - Last Name:MARKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:3550 SHAW AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45208-1445
Mailing Address - Country:US
Mailing Address - Phone:513-871-2090
Mailing Address - Fax:
Practice Address - Street 1:3550 SHAW AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45208-1445
Practice Address - Country:US
Practice Address - Phone:513-871-2090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-06
Last Update Date:2017-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT009212225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist