Provider Demographics
NPI:1285602821
Name:KRECHTING, JEFFREY JOSEPH (MPT PHYSICAL THERAPY)
Entity type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:JOSEPH
Last Name:KRECHTING
Suffix:
Gender:M
Credentials:MPT PHYSICAL THERAPY
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:7567 CENTRAL PARKE BLVD
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-6852
Mailing Address - Country:US
Mailing Address - Phone:513-701-6100
Mailing Address - Fax:513-701-6106
Practice Address - Street 1:530 QUALITY BLVD STE B
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:OH
Practice Address - Zip Code:45014-2289
Practice Address - Country:US
Practice Address - Phone:513-874-1999
Practice Address - Fax:513-874-1653
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2012-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT11304225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0214940Medicaid
OH366632Medicare PIN