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General NPI Number Information
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NPI Number | 1689401390
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Entity Type | Individual
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Provider Name | MADALYN GRACE CANTER PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 09/17/2024
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Last Update Date | 09/17/2024
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Provider Practice Location Address
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Address Line | 7080 GRANTHAM WAY
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City | CINCINNATI
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State | OH
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Zip | 45230-2129
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Country | US
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Telephone | 513-231-7565
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Fax |
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Provider Business Mailing Address
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Address Line | 6369 WAVERLY HILL LN
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City | LOVELAND
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State | OH
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Zip | 45140-8008
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Country | US
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Telephone | 513-400-6069
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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 | PT021143
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License Number State | OH
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