Healthcare Provider Details

I. General information

NPI: 1982990255
Provider Name (Legal Business Name): GEORGE J JOSEPH III DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2011
Last Update Date: 08/23/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

463 OHIO PIKE SUITE 203
CINCINNATI OH
45255-3721
US

IV. Provider business mailing address

463 OHIO PIKE SUITE 203
CINCINNATI OH
45255-3721
US

V. Phone/Fax

Practice location:
  • Phone: 513-247-4340
  • Fax: 513-247-4360
Mailing address:
  • Phone: 513-247-4340
  • Fax: 513-247-4360

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT005825
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT013397
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: