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General NPI Number Information
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NPI Number | 1023817798
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Entity Type | Individual
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Provider Name | MICHAEL LOGAN O'LEARY CPHT
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Gender | Male
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Dates
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Enumeration Date | 03/13/2025
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Last Update Date | 03/13/2025
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Provider Practice Location Address
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Address Line | 1401 STEFFEN AVE
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City | CINCINNATI
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State | OH
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Zip | 45215-2338
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Country | US
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Telephone | 513-588-3635
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Fax |
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Provider Business Mailing Address
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Address Line | 2649 HALIFAX DR
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City | MIDDLETOWN
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State | OH
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Zip | 45044-7192
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Country | US
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Telephone | 513-849-4893
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number | 09316687
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License Number State | OH
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