MEDICARE: COLLEEN MARIE RADUN 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	011626	OH

General Provider Information

NPI Number	:	1750417184
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COLLEEN MARIE RADUN PT

Provider Business Mailing Address
First Line	:	3288 CROOKED TREE DR
Second Line	:
City	:	MASON
State	:	OH
Zip	:	45040-7957
Country	:	US
Telephone Number	:	513-754-0188
Fax Number	:

Provider Business Practice Location Address
First Line	:	8603 CINCINNATI COLUMBUS RD STE J
Second Line	:
City	:	WEST CHESTER
State	:	OH
Zip	:	45069-3569
Country	:	US
Telephone Number	:	513-779-7999
Fax Number	:	513-898-1598

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

Provider Enumeration Date	:	02/27/2007
Last Update Date	:	07/08/2007

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