MEDICARE: MR. MICHAEL J OBERT 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	11407	OH

General Provider Information

NPI Number	:	1881662617
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MICHAEL J OBERT PT

Provider Business Mailing Address
First Line	:	3608 SAINT MARTINS PL
Second Line	:
City	:	CHEVIOT
State	:	OH
Zip	:	45211-5424
Country	:	US
Telephone Number	:	513-481-6580
Fax Number	:

Provider Business Practice Location Address
First Line	:	4358 FERGUSON DR
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45245-1681
Country	:	US
Telephone Number	:	513-943-4400
Fax Number	:

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

Provider Enumeration Date	:	03/09/2006
Last Update Date	:	07/08/2007

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