MEDICARE: GREG A. DICK P.T.

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-010862	OH

General Provider Information

NPI Number	:	1730207515
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GREG A. DICK P.T.

Provider Business Mailing Address
First Line	:	720 COOL SPRINGS BLVD
Second Line	:	SUITE 300
City	:	FRANKLIN
State	:	TN
Zip	:	37067-2626
Country	:	US
Telephone Number	:	615-778-4066
Fax Number	:	615-778-9114

Provider Business Practice Location Address
First Line	:	2702 E KEMPER RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45241-1818
Country	:	US
Telephone Number	:	615-778-4066
Fax Number	:	615-778-9114

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

Provider Enumeration Date	:	03/27/2007
Last Update Date	:	07/08/2007

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