MEDICARE: HOLLY S MICHEL

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	PT019310	OH

General Provider Information

NPI Number	:	1447829171
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HOLLY S MICHEL

Provider Business Mailing Address
First Line	:	6206 VISTA POINT DR
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45247-3398
Country	:	US
Telephone Number	:	513-967-7130
Fax Number	:

Provider Business Practice Location Address
First Line	:	5225 COX SMITH RD
Second Line	:
City	:	MASON
State	:	OH
Zip	:	45040-9276
Country	:	US
Telephone Number	:	513-548-0057
Fax Number	:

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

Provider Enumeration Date	:	06/17/2021
Last Update Date	:	06/17/2021

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Directions to “ HOLLY S MICHEL ” Practice Location

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