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NPI Code Detail

MEDICARE: DYLAN TIM HARDMAN PTA

MEDICARE: DYLAN TIM HARDMAN PTA
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 Assistant09819OH

General Provider Information

NPI Number : 1821561390
Entity Type Code : Individual
Provider Name (Legal Business Name) : DYLAN TIM HARDMAN PTA
Provider Business Mailing Address
First Line : 1227 JACKSON ST APT 417
Second Line :
City : CINCINNATI
State : OH
Zip : 45202-5803
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4320 BRIDGETOWN RD
Second Line :
City : CINCINNATI
State : OH
Zip : 45211-4428
Country : US
Telephone Number :
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/08/2019
Last Update Date : 01/08/2019

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