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NPI Code Detail

MEDICARE: MS. KELLY MARIE RALSTON PTA

MEDICARE: MS. KELLY MARIE RALSTON PTA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225200000XPhysical Therapy Assistant6349OH

General Provider Information

NPI Number : 1134345010
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KELLY MARIE RALSTON PTA
Provider Business Mailing Address
First Line : 1468 RAMBLING HILLS DR
Second Line :
City : CINCINNATI
State : OH
Zip : 45230-2361
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8650 GOVERNORS HILL DR STE 180
Second Line :
City : CINCINNATI
State : OH
Zip : 45249-1399
Country : US
Telephone Number : 513-791-5766
Fax Number : 513-683-1500
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/18/2007
Last Update Date : 07/08/2007

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Directions to “ MS. KELLY MARIE RALSTON PTA” Practice Location

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