MEDICARE: NATHALIE TOWCHIK

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program
2	2255A2300X	Athletic Trainer	AT005073	OH

General Provider Information

NPI Number	:	1699145250
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATHALIE TOWCHIK

Provider Business Mailing Address
First Line	:	1261 IDA ST APT 3
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45202-1587
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3250 VICTORY PKWY
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45207-1457
Country	:	US
Telephone Number	:	513-363-8447
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/25/2015
Last Update Date	:	09/26/2017

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