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Individual

MR. MATT JOHN ERNST

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT, OCS

Contact information

Practice address
350 THOMAS MORE PKWY, STE 130, CRESTVIEW HILLS, KY 41017-5465
(859) 578-7000
Mailing address
7567 CENTRAL PARKE BLVD, MASON, OH 45040-6852
(513) 701-6100

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT-009584
OH
2251X0800X
Orthopedic Physical Therapist
Primary
4066
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0214940
OH
01
P00604756
MEDICARE RAILROAD
OH
Enumeration date
03/14/2006
Last updated
02/07/2017
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