Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251S0007X | Physical Therapist - Sports | 10890 | OH |
NPI | 1366410078 |
---|---|
Provider Name | Mr. Stephen J Minning |
First Address | Independence, KY 41051-9697 |
Second Address | Cincinnati, OH 45221-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/03/2006 |
Last Update Date | 08/07/2007 |