Provider Demographics
NPI:1740482199
Name:GATES, CHERDON CATHERINE (AT, C)
Entity type:Individual
Prefix:MS
First Name:CHERDON
Middle Name:CATHERINE
Last Name:GATES
Suffix:
Gender:F
Credentials:AT, C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:512 FOXTRAIL CIR W
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-2855
Mailing Address - Country:US
Mailing Address - Phone:614-891-6653
Mailing Address - Fax:
Practice Address - Street 1:4605 SAWMILL RD
Practice Address - Street 2:
Practice Address - City:UPPER ARLINGTON
Practice Address - State:OH
Practice Address - Zip Code:43220-2246
Practice Address - Country:US
Practice Address - Phone:614-827-8700
Practice Address - Fax:614-827-7106
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAT.0011472255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer