Provider Demographics
NPI:1104884899
Name:WHETZEL, BETH G (PT)
Entity type:Individual
Prefix:MRS
First Name:BETH
Middle Name:G
Last Name:WHETZEL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:BETH
Other - Middle Name:A
Other - Last Name:GADKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:3773 OLENTANGY RIVER RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-3425
Mailing Address - Country:US
Mailing Address - Phone:614-566-3444
Mailing Address - Fax:614-566-3895
Practice Address - Street 1:3773 OLENTANGY RIVER RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214
Practice Address - Country:US
Practice Address - Phone:614-566-3444
Practice Address - Fax:614-566-3895
Is Sole Proprietor?:No
Enumeration Date:2006-05-02
Last Update Date:2018-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9476225100000X
OHPT011862225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1104884899OtherNPI