MEDICARE: STEVEN KENT GILLESPIE 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
1	225100000X	Physical Therapist	PT020014	OH

General Provider Information

NPI Number	:	1689301269
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEVEN KENT GILLESPIE DPT

Provider Business Mailing Address
First Line	:	791 NEEB RD APT 8
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45233-4638
Country	:	US
Telephone Number	:	513-673-5141
Fax Number	:

Provider Business Practice Location Address
First Line	:	3187 WESTERN ROW RD STE 102
Second Line	:
City	:	MAINEVILLE
State	:	OH
Zip	:	45039-8012
Country	:	US
Telephone Number	:	513-459-8599
Fax Number	:	513-459-8746

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

Provider Enumeration Date	:	08/04/2022
Last Update Date	:	08/04/2022

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