Provider Demographics
NPI:1831634872
Name:RELICH, RICHARD (CPO LPO)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:RELICH
Suffix:
Gender:M
Credentials:CPO LPO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 OVERDALE RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15221-4435
Mailing Address - Country:US
Mailing Address - Phone:412-371-2318
Mailing Address - Fax:
Practice Address - Street 1:305 OVERDALE RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15221-4435
Practice Address - Country:US
Practice Address - Phone:412-371-2318
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-29
Last Update Date:2016-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOH000101222Z00000X
PAPO000118224P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
No222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist