Basic Information
| Provider Information | |||||||||
| NPI: | 1386968790 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BERTSCH | ||||||||
| FirstName: | JULIE | ||||||||
| MiddleName: | ANN | ||||||||
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| Credential: | MTA, ATC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3800 VICTORY PKWY | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452071035 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5132003444 | ||||||||
| FaxNumber: | 5137451963 | ||||||||
| Practice Location | |||||||||
| Address1: | 3800 VICTORY PARKWAY | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 45206 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5132003444 | ||||||||
| FaxNumber: | 5132003444 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/15/2010 | ||||||||
| LastUpdateDate: | 05/30/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2255A2300X | 3490 | OH | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Specialist/Technologist | Athletic Trainer |
No ID Information.