Healthcare Provider Details

I. General information

NPI: 1972603462
Provider Name (Legal Business Name): MATTHEW TODD WILLIAMS P.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/24/2006
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3836 READING RD
CINCINNATI OH
45229-1535
US

IV. Provider business mailing address

9773 JOHN MILLER RD
ALEXANDRIA KY
41001-8923
US

V. Phone/Fax

Practice location:
  • Phone: 859-468-9207
  • Fax: 514-221-0111
Mailing address:
  • Phone: 859-468-9207
  • Fax: 513-221-0111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT-010663
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: