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General NPI Number Information
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NPI Number | 1093316069
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Entity Type | Individual
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Provider Name | KARA ELISE WECKBACH
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Gender | Female
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Dates
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Enumeration Date | 11/05/2020
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Last Update Date | 11/05/2020
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Provider Practice Location Address
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Address Line | 6405 SMALL HOUSE CIR
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City | LOVELAND
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State | OH
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Zip | 45140-7524
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Country | US
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Telephone | 513-312-4749
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Fax |
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Provider Business Mailing Address
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Address Line | 1560 THORNBERRY RD
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City | AMELIA
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State | OH
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Zip | 45102-1721
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Country | US
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Telephone | 513-312-4749
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT014712
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License Number State | OH
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