Healthcare Provider Details

I. General information

NPI: 1053483545
Provider Name (Legal Business Name): CONNIE E CHIU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2006
Last Update Date: 09/08/2021
Certification Date: 09/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8020 LIBERTY WAY
WEST CHESTER OH
45069-2519
US

IV. Provider business mailing address

6480 HARRISON AVE STE 201
CINCINNATI OH
45247-7961
US

V. Phone/Fax

Practice location:
  • Phone: 513-246-2270
  • Fax: 513-860-0713
Mailing address:
  • Phone: 513-246-2270
  • Fax: 513-860-0713

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT010838
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: