1982399366 NPI number — MRS. TRICIA RENEE RIGGENBACH CPHT

Table of content: MRS. TRICIA RENEE RIGGENBACH CPHT (NPI 1982399366)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982399366 NPI number — MRS. TRICIA RENEE RIGGENBACH CPHT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RIGGENBACH
Provider First Name:
TRICIA
Provider Middle Name:
RENEE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
CPHT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
RENNER
Provider Other First Name:
TRICIA
Provider Other Middle Name:
RENEE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
CPHT
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1982399366
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/10/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3131 MAYHAM RD NE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CARROLLTON
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44615-9704
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
330-324-2110
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
340 W MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CARROLLTON
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44615-1348
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
330-627-5229
Provider Business Practice Location Address Fax Number:
330-627-3624
Provider Enumeration Date:
04/10/2023

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183700000X , with the licence number:  09300390 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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