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NPI Code Detail

MEDICARE: PHILIP MONTANO ATC

MEDICARE:   PHILIP  MONTANO  ATC
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
12255A2300XAthletic TrainerAT004655OH

General Provider Information

NPI Number : 1093342164
Entity Type Code : Individual
Provider Name (Legal Business Name) : PHILIP MONTANO ATC
Provider Business Mailing Address
First Line : 2751 O'VARSITY WAY SUITE 265
Second Line :
City : CINCINNATI
State : OH
Zip : 45221-0001
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2571 O'VARSITY WAY SUITE 265
Second Line :
City : CINCINNATI
State : OH
Zip : 45221-0001
Country : US
Telephone Number : 513-556-4352
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/26/2020
Last Update Date : 03/26/2020

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Directions to “ PHILIP MONTANO ATC” Practice Location

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