Provider Demographics
NPI:1679758783
Name:SEFTON, MANDY RENEE (MPT)
Entity type:Individual
Prefix:MRS
First Name:MANDY
Middle Name:RENEE
Last Name:SEFTON
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4360 FERGUSON DR
Mailing Address - Street 2:120
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45245-1682
Mailing Address - Country:US
Mailing Address - Phone:513-943-4400
Mailing Address - Fax:513-943-5323
Practice Address - Street 1:4360 FERGUSON DR
Practice Address - Street 2:120
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45245-1682
Practice Address - Country:US
Practice Address - Phone:513-943-4400
Practice Address - Fax:513-943-5323
Is Sole Proprietor?:No
Enumeration Date:2008-01-08
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH011633225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist