MEDICARE: THERESA M BEDINGHAUS

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	001935	KY
2	225100000X	Physical Therapist	005502	OH

General Provider Information

NPI Number	:	1992936579
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THERESA M BEDINGHAUS

Provider Business Mailing Address
First Line	:	106 FORT BEECH DR
Second Line	:
City	:	SOUTHGATE
State	:	KY
Zip	:	41071-2855
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	106 FORT BEECH DR
Second Line	:
City	:	SOUTHGATE
State	:	KY
Zip	:	41071-2855
Country	:	US
Telephone Number	:	859-781-0817
Fax Number	:	859-781-0387

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

Provider Enumeration Date	:	07/30/2009
Last Update Date	:	07/30/2009

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Directions to “ THERESA M BEDINGHAUS ” Practice Location

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