Provider Demographics
NPI:1407226061
Name:WOLFE, NATHANIEL A (ATS)
Entity Type:Individual
Prefix:MR
First Name:NATHANIEL
Middle Name:A
Last Name:WOLFE
Suffix:
Gender:M
Credentials:ATS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20239 HAMPSHIRE RD
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:OH
Mailing Address - Zip Code:43080-9391
Mailing Address - Country:US
Mailing Address - Phone:740-501-6710
Mailing Address - Fax:
Practice Address - Street 1:3800 VICTORY PKWY
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45207-1035
Practice Address - Country:US
Practice Address - Phone:513-745-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-25
Last Update Date:2015-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer