MEDICARE: MR. KEVIN TODD OCHS 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	002868	KY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P400039953	OTHER	KY	MEDICARE PTAN NUMBER

General Provider Information

NPI Number	:	1629124789
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. KEVIN TODD OCHS PT

Provider Business Mailing Address
First Line	:	370 HIGHLAND PARK DR
Second Line	:	SUITE 1
City	:	RICHMOND
State	:	KY
Zip	:	40475-3546
Country	:	US
Telephone Number	:	859-623-4567
Fax Number	:	859-623-7865

Provider Business Practice Location Address
First Line	:	370 HIGHLAND PARK DR
Second Line	:	SUITE 1
City	:	RICHMOND
State	:	KY
Zip	:	40475-3546
Country	:	US
Telephone Number	:	859-623-4567
Fax Number	:	859-623-7865

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

Provider Enumeration Date	:	01/25/2007
Last Update Date	:	05/08/2014

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