Provider Demographics
NPI:1578212718
Name:PROMOTION MOBILE PHYSICAL THERAPY
Entity type:Organization
Organization Name:PROMOTION MOBILE PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DALE
Authorized Official - Middle Name:
Authorized Official - Last Name:BISHOP
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:859-609-1795
Mailing Address - Street 1:3981 GERMANIA ST APT 1
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45227-3546
Mailing Address - Country:US
Mailing Address - Phone:859-609-1795
Mailing Address - Fax:
Practice Address - Street 1:3981 GERMANIA ST APT 1
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45227-3546
Practice Address - Country:US
Practice Address - Phone:859-609-1795
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-23
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty