Basic Information
Provider Information
NPI: 1306319868
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FRANZER
FirstName: CHAD
MiddleName: WILLIAM
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherCredential:  
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Mailing Information
Address1: 5535 MONTGOMERY RD
Address2:  
City: CINCINNATI
State: OH
PostalCode: 452121848
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 4320 BRIDGETOWN RD
Address2:  
City: CINCINNATI
State: OH
PostalCode: 452114428
CountryCode: US
TelephoneNumber: 5135744550
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/08/2019
LastUpdateDate: 01/08/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225200000X10049OHY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant 

No ID Information.


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