Healthcare Provider Details

I. General information

NPI: 1508650664
Provider Name (Legal Business Name): CITIUS PERFORMANCE THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2025
Last Update Date: 08/23/2026
Certification Date: 08/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

527 ROSS AVE
HAMILTON OH
45013-3225
US

IV. Provider business mailing address

527 ROSS AVE
HAMILTON OH
45013-3225
US

V. Phone/Fax

Practice location:
  • Phone: 614-961-0273
  • Fax:
Mailing address:
  • Phone: 614-961-0273
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code226300000X
TaxonomyKinesiotherapist
License Number
License Number State

VIII. Authorized Official

Name: DR. KENT MITCHELL FORD
Title or Position: OWNER
Credential: PT, DPT, MS
Phone: 614-961-0273