Provider Demographics
NPI:1285687517
Name:REICHOW, GRETCHEN A (LAT, ATC)
Entity Type:Individual
Prefix:MRS
First Name:GRETCHEN
Middle Name:A
Last Name:REICHOW
Suffix:
Gender:F
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 1:5433 DRY CREEK RD
Mailing Address - Street 2:
Mailing Address - City:NORTHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:43619-2681
Mailing Address - Country:US
Mailing Address - Phone:419-304-0023
Mailing Address - Fax:
Practice Address - Street 1:5433 DRY CREEK RD
Practice Address - Street 2:
Practice Address - City:NORTHWOOD
Practice Address - State:OH
Practice Address - Zip Code:43619-2681
Practice Address - Country:US
Practice Address - Phone:419-304-0023
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-18
Last Update Date:2015-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAT 0018272255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer