MEDICARE: KELLY MOFFITT

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	015111	OH

General Provider Information

NPI Number	:	1659778595
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELLY MOFFITT

Provider Business Mailing Address
First Line	:	7927 SADDLEBACK PL
Second Line	:
City	:	MAINEVILLE
State	:	OH
Zip	:	45039-9366
Country	:	US
Telephone Number	:	513-677-0807
Fax Number	:

Provider Business Practice Location Address
First Line	:	700 W PETE ROSE WAY
Second Line	:	SUITE 225
City	:	CINCINNATI
State	:	OH
Zip	:	45203-1892
Country	:	US
Telephone Number	:	513-381-3380
Fax Number	:

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

Provider Enumeration Date	:	11/20/2014
Last Update Date	:	11/20/2014

Similar Medicare Providers

1740283282 — COMMUNITY IMPACT, INC.
Practice Location Address:

700 W PETE ROSE WAY , SUITE 350
CINCINNATI, OH
45203-1892

Practice Phone: 513-319-3325
Practice Fax:

1063652527 — DECLARE THERAPY CENTER INC
Practice Location Address:

700 W PETE ROSE WAY
CINCINNATI, OH
45203-1892

Practice Phone: 513-290-7908
Practice Fax: 513-834-7052

1427482645 — JOANN EUGENIA ERBY PTA
Practice Location Address:

700 W PETE ROSE WAY
CINCINNATI, OH
45203-1892

Practice Phone: 513-381-3380
Practice Fax:

1790115079 — MATTHEW ALLARD
Practice Location Address:

700 W PETE ROSE WAY , #225
CINCINNATI, OH
45203-1892

Practice Phone: 888-752-9640
Practice Fax:

1033590914 — KATHERINE STOLL LPC-CR, CDCA 1
Practice Location Address:

700 W PETE ROSE WAY , SUITE 349
CINCINNATI, OH
45203-1892

Practice Phone: 513-834-7050
Practice Fax: 513-834-7052

1992255731 — MISS CYNTHIA VANDEILEN OTR/L
Practice Location Address:

700 W PETE ROSE WAY
CINCINNATI, OH
45203-1892

Practice Phone: 513-381-3380
Practice Fax:

Directions to “ KELLY MOFFITT ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.