MEDICARE: TRENA M HARDY PT

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
1	225100000X	Physical Therapist	19133	OH

General Provider Information

NPI Number	:	1154587111
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRENA M HARDY PT

Provider Business Mailing Address
First Line	:	136 S LUDLOW ST
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45402-1813
Country	:	US
Telephone Number	:	937-542-3000
Fax Number	:

Provider Business Practice Location Address
First Line	:	136 S LUDLOW ST
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45402-1813
Country	:	US
Telephone Number	:	937-542-3000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/30/2008
Last Update Date	:	10/29/2024

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