Provider Demographics
NPI:1053315911
Name:CONTI, CHARLES P (PT)
Entity type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:P
Last Name:CONTI
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:694 AUSTRIAN CT
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:OH
Mailing Address - Zip Code:45150-6566
Mailing Address - Country:US
Mailing Address - Phone:513-575-0770
Mailing Address - Fax:
Practice Address - Street 1:10547 MONTGOMERY RD
Practice Address - Street 2:STE 700
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45242-4418
Practice Address - Country:US
Practice Address - Phone:513-891-4600
Practice Address - Fax:513-936-3493
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT035892251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH10939239Medicaid
OH0747223Medicare ID - Type Unspecified