Provider Demographics
NPI:1386127652
Name:LANGE, CHARLOTTE J (DPT)
Entity type:Individual
Prefix:
First Name:CHARLOTTE
Middle Name:J
Last Name:LANGE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:CHARLOTTE
Other - Middle Name:J
Other - Last Name:THURNAUER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:715 CONGRESS PARK DR
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45459-4044
Mailing Address - Country:US
Mailing Address - Phone:513-802-1929
Mailing Address - Fax:513-802-1929
Practice Address - Street 1:715 CONGRESS PARK DR
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:45459-4044
Practice Address - Country:US
Practice Address - Phone:513-802-1929
Practice Address - Fax:888-972-7349
Is Sole Proprietor?:No
Enumeration Date:2018-09-12
Last Update Date:2021-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT017394225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist