Provider Demographics
NPI:1447308226
Name:GATCHELL, RYAN B (OTR)
Entity type:Individual
Prefix:MR
First Name:RYAN
Middle Name:B
Last Name:GATCHELL
Suffix:
Gender:M
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SUNAPEE
Mailing Address - State:NH
Mailing Address - Zip Code:03782
Mailing Address - Country:US
Mailing Address - Phone:603-867-4444
Mailing Address - Fax:
Practice Address - Street 1:10606 RT 106 SOUTH
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:VT
Practice Address - Zip Code:05091
Practice Address - Country:US
Practice Address - Phone:802-457-4213
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0720000319225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist