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NPI Code Detail

MEDICARE: DR. DUSTIN MENETREY PT, DPT

MEDICARE:  DR. DUSTIN  MENETREY  PT, 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
1225100000XPhysical TherapistPT016817OH
2225100000XPhysical Therapist

General Provider Information

NPI Number : 1528531522
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DUSTIN MENETREY PT, DPT
Provider Business Mailing Address
First Line : 404 SUNRISE CT
Second Line :
City : LUDLOW
State : KY
Zip : 41016-1701
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1701 LLANFAIR AVE
Second Line :
City : CINCINNATI
State : OH
Zip : 45224-2972
Country : US
Telephone Number : 513-681-4230
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/02/2019
Last Update Date : 02/15/2019

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