Individual ProviderBryn ThatcherStudent in an Organized Health Care Education/Training ProgramStudent, Health CarePractice Address1 Wyoming St, Dayton, OH 45409-2722(937) 208-3882PECOS EnrollmentBased on the most recent information from CMS, provider Bryn Thatcher is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 8 days ago.Profile DetailsProvider ID1700397825Provider TypeIndividualFull NameThatcher, BrynCredentialMDGenderFemaleSole ProprietorNoEnumeration Date10/16/2017Last Updated7/30/2025Contact InformationPractice LocationPractice Address1 Wyoming St, Dayton, OH 45409-2722Phone(937) 208-3882FaxUnlisted FaxMailing LocationMailing Address1 Wyoming St., Attn: Pam Shank, Dayton, OH 45409Phone(937) 208-3882FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode390200000XPrimaryDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicense57.259516OhioCode207Q00000XDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicense11022510AIndianaCode101YM0800XDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseC.1300114OhioCode207QA0401XDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicense57.259516Ohio