Provider Demographics
NPI:1497151427
Name:GAASCH, GEANA R (MS, ATC)
Entity Type:Individual
Prefix:
First Name:GEANA
Middle Name:R
Last Name:GAASCH
Suffix:
Gender:F
Credentials:MS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15297 SPRING VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:WI
Mailing Address - Zip Code:53543-9606
Mailing Address - Country:US
Mailing Address - Phone:970-640-1197
Mailing Address - Fax:
Practice Address - Street 1:15297 SPRING VALLEY RD
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:WI
Practice Address - Zip Code:53543-9606
Practice Address - Country:US
Practice Address - Phone:970-640-1197
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-19
Last Update Date:2014-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer