Healthcare Provider Details
I. General information
NPI: 1588176093
Provider Name (Legal Business Name): MIERS PHYSICAL THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/25/2017
Last Update Date: 10/25/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10776 MONTGOMERY RD
CINCINNATI OH
45242-3213
US
IV. Provider business mailing address
10776 MONTGOMERY RD
CINCINNATI OH
45242-3213
US
V. Phone/Fax
- Phone: 724-321-2493
- Fax:
- Phone: 724-321-2493
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DAVID
SCOTT
MIERS
Title or Position: OWNER
Credential: PT, OCS, FAAOMPT, CS
Phone: 724-321-2493