=====================================================
General NPI Number Information
=====================================================
NPI Number | 1699465567
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | NINA DANIELLE BENDIXEN PT, DPT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/12/2023
-----------------------------------------------------
Last Update Date | 06/12/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 267 W NATIONAL RD
-----------------------------------------------------
City | VANDALIA
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45377
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 937-400-1155
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5636 BELLEFONTAINE RD
-----------------------------------------------------
City | HUBER HEIGHTS
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45424-4135
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number | PT020469
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------