MEDICARE: MISS TERESA EILEEN KNEIPP 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	PT-08646	OH

General Provider Information

NPI Number	:	1699879254
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS TERESA EILEEN KNEIPP PT

Provider Business Mailing Address
First Line	:	1109 MADELEINE CIR
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45231-4605
Country	:	US
Telephone Number	:	513-931-2441
Fax Number	:

Provider Business Practice Location Address
First Line	:	2300 MONTANA AVE
Second Line	:	SUITE 420
City	:	CINCINNATI
State	:	OH
Zip	:	45211-3829
Country	:	US
Telephone Number	:	513-662-3400
Fax Number	:	513-662-3071

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

Provider Enumeration Date	:	09/12/2006
Last Update Date	:	07/08/2007

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