Provider Demographics
NPI:1629569728
Name:FINCH, TIANDRA MARTINA (ATC, LAT, MBA)
Entity Type:Individual
Prefix:
First Name:TIANDRA
Middle Name:MARTINA
Last Name:FINCH
Suffix:
Gender:F
Credentials:ATC, LAT, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2950 DUBLIN ARBOR LN
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-2049
Mailing Address - Country:US
Mailing Address - Phone:937-304-5693
Mailing Address - Fax:
Practice Address - Street 1:2950 DUBLIN ARBOR LN
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43017-2049
Practice Address - Country:US
Practice Address - Phone:937-304-5693
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-23
Last Update Date:2018-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAT0032612255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer