Individual
DUOC HA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
440 LAFAYETTE AVE, CINCINNATI, OH 45220-1022
(513) 221-1562
Mailing address
4129 CLOUGH LN, CINCINNATI, OH 45245-1708
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
01909
OH
Other
Enumeration date
07/24/2009
Last updated
07/24/2009
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