Healthcare Provider Details

I. General information

NPI: 1336101658
Provider Name (Legal Business Name): PERRY DAVID DENEHY AT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2006
Last Update Date: 09/14/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 E BUSINESS WAY
SHARONVILLE OH
45241
US

IV. Provider business mailing address

500 E BUSINESS WAY
SHARONVILLE OH
45241
US

V. Phone/Fax

Practice location:
  • Phone: 513-354-3700
  • Fax: 513-489-7425
Mailing address:
  • Phone: 513-354-3700
  • Fax: 513-489-7425

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberAT271
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberAT-271
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: