MEDICARE: ELISABETH J KNOSE

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	PT-014079	OH
2	225100000X	Physical Therapist	PT-006479	KY

General Provider Information

NPI Number	:	1407347222
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELISABETH J KNOSE

Provider Business Mailing Address
First Line	:	7567 CENTRAL PARKE BLVD STE A
Second Line	:
City	:	MASON
State	:	OH
Zip	:	45040-6855
Country	:	US
Telephone Number	:	513-701-6100
Fax Number	:

Provider Business Practice Location Address
First Line	:	350 THOMAS MORE PKWY STE 130
Second Line	:
City	:	CRESTVIEW HILLS
State	:	KY
Zip	:	41017-5119
Country	:	US
Telephone Number	:	859-578-7000
Fax Number	:

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

Provider Enumeration Date	:	05/29/2018
Last Update Date	:	05/29/2018

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