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NPI Code Detail

MEDICARE: KELLY ROBINSON

MEDICARE: KELLY ROBINSON
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
1225200000XPhysical Therapy AssistantPTA011261OH

General Provider Information

NPI Number : 1710415096
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELLY ROBINSON
Provider Business Mailing Address
First Line : 8302 WOOSTER PIKE APT 13
Second Line :
City : CINCINNATI
State : OH
Zip : 45227-4045
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5435 KENWOOD RD
Second Line :
City : CINCINNATI
State : OH
Zip : 45227-1328
Country : US
Telephone Number : 513-258-2815
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/31/2017
Last Update Date : 05/31/2017

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Directions to “ KELLY ROBINSON ” Practice Location

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