Provider Demographics
NPI:1063719797
Name:MEIBERS, KATHRYN LEIGH (DPT)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:LEIGH
Last Name:MEIBERS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:LEIGH
Other - Last Name:RUZICKA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6480 HARRISON AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45247-7961
Mailing Address - Country:US
Mailing Address - Phone:513-354-7662
Mailing Address - Fax:513-354-7651
Practice Address - Street 1:1200 GLENDALE MILFORD RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45215-1209
Practice Address - Country:US
Practice Address - Phone:513-733-3370
Practice Address - Fax:513-786-7893
Is Sole Proprietor?:No
Enumeration Date:2011-02-15
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT018366225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4288873OtherBCBS OF TN
TN4288873OtherBCBS OF TN