Provider Demographics
NPI:1962185058
Name:GASCHO, ZACHARY DANIEL
Entity type:Individual
Prefix:
First Name:ZACHARY
Middle Name:DANIEL
Last Name:GASCHO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1515 7TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55906-4281
Mailing Address - Country:US
Mailing Address - Phone:706-755-7049
Mailing Address - Fax:
Practice Address - Street 1:140 ELTON HILLS LN NW STE 100
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55901-3553
Practice Address - Country:US
Practice Address - Phone:507-722-1508
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-07
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN107237225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist