MEDICARE: DR. CAROLINE TIMONEY COLVIN 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	2251P0200X	Pediatric Physical Therapist
2	2251P0200X	Pediatric Physical Therapist	003516	KY

General Provider Information

NPI Number	:	1043219264
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CAROLINE TIMONEY COLVIN DPT

Provider Business Mailing Address
First Line	:	3430 BURNET AVE # 4007
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45229-2833
Country	:	US
Telephone Number	:
Fax Number	:	859-344-4771

Provider Business Practice Location Address
First Line	:	3430 BURNET AVE # 4007
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45229-2833
Country	:	US
Telephone Number	:	859-344-4769
Fax Number	:	859-344-4771

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

Provider Enumeration Date	:	07/19/2005
Last Update Date	:	10/23/2018

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