Provider Demographics
NPI:1932311909
Name:VENTRESCA, CATHLENE ELLEN (ATC, CFO)
Entity Type:Individual
Prefix:
First Name:CATHLENE
Middle Name:ELLEN
Last Name:VENTRESCA
Suffix:
Gender:F
Credentials:ATC, CFO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2967 AVALON RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43221-2601
Mailing Address - Country:US
Mailing Address - Phone:614-487-1476
Mailing Address - Fax:
Practice Address - Street 1:2967 AVALON RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43221-2601
Practice Address - Country:US
Practice Address - Phone:614-487-1476
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH9524912255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer