Healthcare Provider Details

I. General information

NPI: 1477110708
Provider Name (Legal Business Name): GABRIELA V NIEHAUSER PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: GABRIELA V BOBADILLA

II. Dates (important events)

Enumeration Date: 05/22/2019
Last Update Date: 01/09/2024
Certification Date: 01/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 E BUSINESS WAY
CINCINNATI OH
45241-2374
US

IV. Provider business mailing address

6480 HARRISON AVE STE 201
CINCINNATI OH
45247-7961
US

V. Phone/Fax

Practice location:
  • Phone: 513-354-7777
  • Fax: 513-354-7778
Mailing address:
  • Phone: 513-354-3700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT018090
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: