Healthcare Provider Details

I. General information

NPI: 1427735067
Provider Name (Legal Business Name): ZACHARY FRANCEK MAT, AT, ATC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/04/2023
Last Update Date: 08/01/2026
Certification Date: 08/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7430 BRIDGE POINT PASS
CINCINNATI OH
45248-1916
US

IV. Provider business mailing address

2112 SUNRUSH CT
GROVE CITY OH
43123-8411
US

V. Phone/Fax

Practice location:
  • Phone: 855-718-4810
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberAT007145
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: