Basic Information
| Provider Information | |||||||||
| NPI: | 1366889560 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NEUENSCHWANDER | ||||||||
| FirstName: | ALEAH | ||||||||
| MiddleName: | JOY | ||||||||
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| Credential: | ATC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 15101 BAUMGARTNER RD | ||||||||
| Address2: | |||||||||
| City: | DALTON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 446189240 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3304661682 | ||||||||
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| Practice Location | |||||||||
| Address1: | 365 S CROWN HILL RD | ||||||||
| Address2: | |||||||||
| City: | ORRVILLE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 446679527 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3306844732 | ||||||||
| FaxNumber: | 3306844742 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/29/2013 | ||||||||
| LastUpdateDate: | 05/29/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2255A2300X | 002840 | OH | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Specialist/Technologist | Athletic Trainer |
No ID Information.