MEDICARE: AALIYAH BRLETIC PT, DPT, CSCS

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	PT022249	OH

General Provider Information

NPI Number	:	1972458164
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AALIYAH BRLETIC PT, DPT, CSCS

Provider Business Mailing Address
First Line	:	9675 LAKESIDE ESTATES DR
Second Line	:
City	:	LOVELAND
State	:	OH
Zip	:	45140-9085
Country	:	US
Telephone Number	:	614-973-0212
Fax Number	:

Provider Business Practice Location Address
First Line	:	11258 CORNELL PARK DR STE 612
Second Line	:
City	:	BLUE ASH
State	:	OH
Zip	:	45242-1833
Country	:	US
Telephone Number	:	513-256-2610
Fax Number	:

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

Provider Enumeration Date	:	03/03/2026
Last Update Date	:	03/03/2026

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