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NPI Code Detail

MEDICARE: MR. KEVIN MICHAEL GRADY MPT

MEDICARE:  MR. KEVIN MICHAEL GRADY  MPT
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 Therapist10312OH

General Provider Information

NPI Number : 1831168160
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. KEVIN MICHAEL GRADY MPT
Provider Business Mailing Address
First Line : 1391 HAZELGROVE DR
Second Line :
City : CINCINNATI
State : OH
Zip : 45240-1117
Country : US
Telephone Number : 513-379-7971
Fax Number :
Provider Business Practice Location Address
First Line : 1198 SMILEY AVE
Second Line :
City : CINCINNATI
State : OH
Zip : 45240-1865
Country : US
Telephone Number : 513-671-6362
Fax Number : 513-671-6368
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/17/2006
Last Update Date : 07/08/2007

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Directions to “ MR. KEVIN MICHAEL GRADY MPT” Practice Location

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