Provider Demographics
NPI:1932367877
Name:ESPICH, GRETCHEN JAYNE (MSPT)
Entity Type:Individual
Prefix:MS
First Name:GRETCHEN
Middle Name:JAYNE
Last Name:ESPICH
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:MRS
Other - First Name:GRETCHEN
Other - Middle Name:JAYNE
Other - Last Name:ZARTMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSPT
Mailing Address - Street 1:5310 MERCHANDISE DR
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46825-5140
Mailing Address - Country:US
Mailing Address - Phone:260-484-9491
Mailing Address - Fax:260-484-9451
Practice Address - Street 1:5310 MERCHANDISE DR
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46825-5140
Practice Address - Country:US
Practice Address - Phone:260-484-9491
Practice Address - Fax:260-484-9451
Is Sole Proprietor?:No
Enumeration Date:2008-05-28
Last Update Date:2010-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05005083225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist