Provider Demographics
NPI:1063802486
Name:ZARTMAN, WILLIAM IV (ATC, PTA)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:
Last Name:ZARTMAN
Suffix:IV
Gender:M
Credentials:ATC, PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27480 STANDLEY RD
Mailing Address - Street 2:
Mailing Address - City:DEFIANCE
Mailing Address - State:OH
Mailing Address - Zip Code:43512-8949
Mailing Address - Country:US
Mailing Address - Phone:419-439-1167
Mailing Address - Fax:
Practice Address - Street 1:27480 STANDLEY RD
Practice Address - Street 2:
Practice Address - City:DEFIANCE
Practice Address - State:OH
Practice Address - Zip Code:43512-8949
Practice Address - Country:US
Practice Address - Phone:419-439-1167
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-24
Last Update Date:2015-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAT.0024502255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer