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General NPI Number Information
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NPI Number | 1518655034
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Entity Type | Organization
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Legal Business Name | NICOLE BERTKE OTR/L, LLC
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Dates
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Enumeration Date | 04/25/2023
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Last Update Date | 05/10/2023
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Provider Practice Location Address
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Address Line | 2859 BOUDINOT AVE
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City | CINCINNATI
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State | OH
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Zip | 45238-1606
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Country | US
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Telephone | 513-538-3990
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Fax |
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Provider Business Mailing Address
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Address Line | 6753 SANDOVER DR
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City | CINCINNATI
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State | OH
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Zip | 45233-1447
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Country | US
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Telephone | 513-641-9807
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Fax |
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Authorized Official
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Title or Position | BUSINESS OWNER
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Name | NICOLE BERTKE
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Credential |
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Telephone | 513-641-9807
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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