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NPI Code Detail

MEDICARE: VIVIAN PHAN DPT

MEDICARE: VIVIAN PHAN 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 TherapistCP054221TOH

General Provider Information

NPI Number : 1831034883
Entity Type Code : Individual
Provider Name (Legal Business Name) : VIVIAN PHAN DPT
Provider Business Mailing Address
First Line : 6480 HARRISON AVE STE 201
Second Line :
City : CINCINNATI
State : OH
Zip : 45247-7961
Country : US
Telephone Number : 205-545-2717
Fax Number : 513-354-7651
Provider Business Practice Location Address
First Line : 1507 SPRINGFIELD PIKE
Second Line :
City : CINCINNATI
State : OH
Zip : 45215-1437
Country : US
Telephone Number : 513-873-3251
Fax Number : 513-354-7651
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/23/2026
Last Update Date : 04/23/2026

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Directions to “ VIVIAN PHAN DPT” Practice Location

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