Provider Demographics
NPI:1841611035
Name:KINCHES, MARK A (RRT)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:A
Last Name:KINCHES
Suffix:
Gender:M
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3175 OVERDALE DR
Mailing Address - Street 2:
Mailing Address - City:RICHFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44286-9519
Mailing Address - Country:US
Mailing Address - Phone:216-534-0133
Mailing Address - Fax:
Practice Address - Street 1:6300 HALLE DR
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44125-4618
Practice Address - Country:US
Practice Address - Phone:412-360-9148
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-15
Last Update Date:2013-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH37672278S1500X, 2279S1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2279S1500XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredSNF/Subacute Care
No2278S1500XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedSNF/Subacute Care