Provider Demographics
NPI:1255543229
Name:FAIL, RICHARD ALAN (ATC)
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:ALAN
Last Name:FAIL
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2727 COURTNEY PL
Mailing Address - Street 2:
Mailing Address - City:LEWIS CENTER
Mailing Address - State:OH
Mailing Address - Zip Code:43035-8987
Mailing Address - Country:US
Mailing Address - Phone:740-549-1049
Mailing Address - Fax:614-873-7342
Practice Address - Street 1:8300 HYLAND CROY RD
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43016-7016
Practice Address - Country:US
Practice Address - Phone:614-718-8282
Practice Address - Fax:614-873-7342
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2014-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAT000402255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer