Healthcare Provider Details

I. General information

NPI: 1417509761
Provider Name (Legal Business Name): DRAYER PHYSICAL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2019
Last Update Date: 07/16/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5050 E GALBRAITH RD STE A
CINCINNATI OH
45236-2886
US

IV. Provider business mailing address

8205 PRESIDENTS DR
HUMMELSTOWN PA
17036-8621
US

V. Phone/Fax

Practice location:
  • Phone: 513-376-9571
  • Fax: 513-386-9849
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: KEVIN JOHANNESON
Title or Position: VP REVENUE CYCLE
Credential:
Phone: 423-238-2313