Individual
CONNIE SUE BAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
540 LINCOLN PARK BLVD, SUITE 350, KETTERING, OH 45429-6401
(937) 312-8100
(937) 312-8101
Mailing address
4700 SMITH RD, SUITE A, CINCINNATI, OH 45212-2787
(513) 619-6819
(513) 645-2393
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT001778
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2695810
—
OH
Enumeration date
07/24/2006
Last updated
01/11/2011
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