MEDICARE: POLKA DOT KIDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	225100000X	Physical Therapist
2	235Z00000X	Speech-Language Pathologist
3	225X00000X	Occupational Therapist

General Provider Information

NPI Number	:	1619672433
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	POLKA DOT KIDS

Provider Business Mailing Address
First Line	:	9096 MUZETTE CT
Second Line	:
City	:	MIAMISBURG
State	:	OH
Zip	:	45342-7408
Country	:	US
Telephone Number	:	513-259-3236
Fax Number	:

Provider Business Practice Location Address
First Line	:	7333 PARAGON RD STE 230
Second Line	:
City	:	WASHINGTON TOWNSHIP
State	:	OH
Zip	:	45459-4161
Country	:	US
Telephone Number	:	513-930-0224
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MEGAN E MILLER
Credential	:	OTR/L
Telephone Number	:	513-259-3236

Provider Enumeration Date	:	04/03/2023
Last Update Date	:	04/03/2023

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Directions to “POLKA DOT KIDS ” Practice Location

Language	Start Address	Practice Location

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