MEDICARE: MR. JAMES M PAUL 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	8587	OH

General Provider Information

NPI Number	:	1720056856
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JAMES M PAUL PT

Provider Business Mailing Address
First Line	:	4105 WOODMONT DR
Second Line	:
City	:	BATAVIA
State	:	OH
Zip	:	45103-2567
Country	:	US
Telephone Number	:	513-753-6208
Fax Number	:

Provider Business Practice Location Address
First Line	:	7695 BEECHMONT AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45255-4216
Country	:	US
Telephone Number	:	513-232-1847
Fax Number	:	513-232-2491

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

Provider Enumeration Date	:	03/14/2006
Last Update Date	:	07/08/2007

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