Provider Demographics
NPI:1659569937
Name:FRITSCH, JASON WESLEY (MOT, OTR/L)
Entity Type:Individual
Prefix:MR
First Name:JASON
Middle Name:WESLEY
Last Name:FRITSCH
Suffix:
Gender:M
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1069 KLOTZ RD
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:OH
Mailing Address - Zip Code:43402-4828
Mailing Address - Country:US
Mailing Address - Phone:419-728-7019
Mailing Address - Fax:419-728-7020
Practice Address - Street 1:1725 WESTERN AVE
Practice Address - Street 2:SUITE B
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-1345
Practice Address - Country:US
Practice Address - Phone:419-422-5526
Practice Address - Fax:419-422-5562
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-11
Last Update Date:2012-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6991225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
H089200Medicare PIN