MEDICARE: PETER ROBERT MCBRIDE 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	PT008304	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PT008304	OTHER	OH	STATE OF OHIO

General Provider Information

NPI Number	:	1801864731
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PETER ROBERT MCBRIDE PT

Provider Business Mailing Address
First Line	:	6441 MARATHON EDENTON RD
Second Line	:
City	:	GOSHEN
State	:	OH
Zip	:	45122-9500
Country	:	US
Telephone Number	:	513-625-1694
Fax Number	:

Provider Business Practice Location Address
First Line	:	3187 WESTERN ROW RD
Second Line	:	SUITE 102
City	:	MAINEVILLE
State	:	OH
Zip	:	45039-8045
Country	:	US
Telephone Number	:	513-459-8599
Fax Number	:	513-459-8746

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

Provider Enumeration Date	:	03/08/2006
Last Update Date	:	03/27/2025

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Directions to “ PETER ROBERT MCBRIDE PT” Practice Location

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