Provider Demographics
NPI:1730954132
Name:RIASE, DAWN L
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:L
Last Name:RIASE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DAWN
Other - Middle Name:L
Other - Last Name:TORKELSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ATC
Mailing Address - Street 1:4391 NEVILLE RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44121-3764
Mailing Address - Country:US
Mailing Address - Phone:605-521-3104
Mailing Address - Fax:
Practice Address - Street 1:1311 VINE ST
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45202-7118
Practice Address - Country:US
Practice Address - Phone:866-456-7846
Practice Address - Fax:513-306-4004
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-16
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAT0037202255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer