Healthcare Provider Details

I. General information

NPI: 1881951663
Provider Name (Legal Business Name): THOMAS L WALSH DBA ABILITIES IN MOTION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2012
Last Update Date: 04/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11151 KENWOOD RD
BLUE ASH OH
45242-1817
US

IV. Provider business mailing address

5701 CHEVIOT RD
CINCINNATI OH
45247-7007
US

V. Phone/Fax

Practice location:
  • Phone: 513-489-9400
  • Fax: 513-489-9403
Mailing address:
  • Phone: 513-245-0253
  • Fax: 513-245-0258

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0900X
TaxonomyAmputee Clinic/Center
License NumberLP133
License Number StateOH

VIII. Authorized Official

Name: THOMAS WALSH
Title or Position: OWNER / PROSTHETIST ORTHOTIST
Credential: C.P.O., L.P.O.
Phone: 513-256-8272