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NPI Code Detail

MEDICARE: JUSTIN MICHAEL PENNINGTON DPT

MEDICARE: JUSTIN MICHAEL PENNINGTON DPT
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
1225100000XPhysical TherapistPT022122OH
2208100000XPhysical Medicine & Rehabilitation Physician16878TN

General Provider Information

NPI Number : 1336009836
Entity Type Code : Individual
Provider Name (Legal Business Name) : JUSTIN MICHAEL PENNINGTON DPT
Provider Business Mailing Address
First Line : 2313 PARK AVE APT 1
Second Line :
City : NORWOOD
State : OH
Zip : 45212-3309
Country : US
Telephone Number : 276-206-7454
Fax Number :
Provider Business Practice Location Address
First Line : 6480 HARRISON AVE
Second Line :
City : CINCINNATI
State : OH
Zip : 45247-7961
Country : US
Telephone Number : 513-354-3700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/17/2025
Last Update Date : 12/09/2025

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Directions to “ JUSTIN MICHAEL PENNINGTON DPT” Practice Location

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