MEDICARE: ELIZABETH KOEHL

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	224Z00000X	Occupational Therapy Assistant	008526	OH

General Provider Information

NPI Number	:	1922889534
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH KOEHL

Provider Business Mailing Address
First Line	:	5696 BRIDGETOWN RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45248-4382
Country	:	US
Telephone Number	:	859-512-5201
Fax Number	:

Provider Business Practice Location Address
First Line	:	70 DAMON RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45218-1041
Country	:	US
Telephone Number	:	859-512-5201
Fax Number	:

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

Provider Enumeration Date	:	10/10/2023
Last Update Date	:	10/10/2023

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Directions to “ ELIZABETH KOEHL ” Practice Location

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