Provider Demographics
NPI:1669938080
Name:RATSCH, COREY MICHAEL
Entity type:Individual
Prefix:MR
First Name:COREY
Middle Name:MICHAEL
Last Name:RATSCH
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 1:1731 TRENTON CT
Mailing Address - Street 2:
Mailing Address - City:CRANBERRY TWP
Mailing Address - State:PA
Mailing Address - Zip Code:16066-7134
Mailing Address - Country:US
Mailing Address - Phone:217-836-4455
Mailing Address - Fax:
Practice Address - Street 1:8000 CRANBERRY SPRINGS DR
Practice Address - Street 2:
Practice Address - City:CRANBERRY TWP
Practice Address - State:PA
Practice Address - Zip Code:16066-6687
Practice Address - Country:US
Practice Address - Phone:217-836-4455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-11
Last Update Date:2022-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARTO0005462255A2300X
2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer