Healthcare Provider Details

I. General information

NPI: 1710813134
Provider Name (Legal Business Name): ELIZABETH CONWAY DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11003 MONTGOMERY RD STE A
CINCINNATI OH
45249-2306
US

IV. Provider business mailing address

7567 CENTRAL PARKE BLVD STE A
MASON OH
45040-6855
US

V. Phone/Fax

Practice location:
  • Phone: 513-469-1444
  • Fax: 513-247-9484
Mailing address:
  • Phone: 513-701-6100
  • Fax: 513-701-6106

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT-022491
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberCP058976T
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: