Provider Demographics
NPI:1023720430
Name:CATTELL, MICHAEL LYNN
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:LYNN
Last Name:CATTELL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5151 MOLINE MARTIN RD
Mailing Address - Street 2:
Mailing Address - City:WALBRIDGE
Mailing Address - State:OH
Mailing Address - Zip Code:43465-9759
Mailing Address - Country:US
Mailing Address - Phone:419-704-9697
Mailing Address - Fax:
Practice Address - Street 1:5151 MOLINE MARTIN RD
Practice Address - Street 2:
Practice Address - City:WALBRIDGE
Practice Address - State:OH
Practice Address - Zip Code:43465-9759
Practice Address - Country:US
Practice Address - Phone:419-704-9697
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-16
Last Update Date:2022-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide