MEDICARE: BRADEN HURST DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	006895	KY
2	2251X0800X	Orthopedic Physical Therapist	CPO18924T	OH

General Provider Information

NPI Number	:	1033662788
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRADEN HURST DPT

Provider Business Mailing Address
First Line	:	222 PIEDMONT AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45219-4231
Country	:	US
Telephone Number	:	502-510-2975
Fax Number	:

Provider Business Practice Location Address
First Line	:	222 PIEDMONT AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45219-4231
Country	:	US
Telephone Number	:	513-621-7777
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/29/2016
Last Update Date	:	05/05/2023

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Directions to “ BRADEN HURST DPT” Practice Location

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