Provider Demographics
NPI:1245810118
Name:FRESHOUR, MARITZA RACHEL
Entity type:Individual
Prefix:MRS
First Name:MARITZA
Middle Name:RACHEL
Last Name:FRESHOUR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5276 PUNDT RD
Mailing Address - Street 2:
Mailing Address - City:LEWISBURG
Mailing Address - State:OH
Mailing Address - Zip Code:45338-9714
Mailing Address - Country:US
Mailing Address - Phone:937-610-6088
Mailing Address - Fax:
Practice Address - Street 1:5276 PUNDT RD
Practice Address - Street 2:
Practice Address - City:LEWISBURG
Practice Address - State:OH
Practice Address - Zip Code:45338-9714
Practice Address - Country:US
Practice Address - Phone:937-610-6088
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-13
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care