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General NPI Number Information
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NPI Number | 1174775464
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Entity Type | Individual
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Provider Name | NICHOLAS GODBY
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Gender | Male
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Dates
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Enumeration Date | 10/17/2008
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Last Update Date | 03/22/2023
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Provider Practice Location Address
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Address Line | 9250 BLUE ASH RD
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City | BLUE ASH
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State | OH
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Zip | 45242-6822
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Country | US
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Telephone | 513-792-7441
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Fax | 513-791-4042
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Provider Business Mailing Address
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Address Line | 9250 BLUE ASH RD
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City | BLUE ASH
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State | OH
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Zip | 45242-6822
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Country | US
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Telephone | 513-792-7441
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Fax | 513-791-4042
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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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 35.094823
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License Number State | OH
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