MEDICARE: BROOKE ALBERS OTD

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	208100000X	Physical Medicine & Rehabilitation Physician	OT012319	OH

General Provider Information

NPI Number	:	1700580776
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BROOKE ALBERS OTD

Provider Business Mailing Address
First Line	:	2680 COLUMBIA TRL
Second Line	:
City	:	LOVELAND
State	:	OH
Zip	:	45140-5527
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4400 GLEN ESTE WITHAMSVILLE RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45245-1306
Country	:	US
Telephone Number	:	513-752-3710
Fax Number	:

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

Provider Enumeration Date	:	03/27/2023
Last Update Date	:	03/27/2023

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