MEDICARE: KENJA CARINO PT

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	6771	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083238117
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KENJA CARINO PT

Provider Business Mailing Address
First Line	:	100 ARROW SPRINGS BLVD
Second Line	:
City	:	LEBANON
State	:	OH
Zip	:	45036-7002
Country	:	US
Telephone Number	:	513-282-7150
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 ARROW SPRINGS BLVD STE 1000
Second Line	:
City	:	LEBANON
State	:	OH
Zip	:	45036-7019
Country	:	US
Telephone Number	:	513-282-7150
Fax Number	:

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

Provider Enumeration Date	:	06/04/2020
Last Update Date	:	05/20/2025

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Directions to “ KENJA CARINO PT” Practice Location

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