Provider Demographics
NPI:1215685763
Name:PUTHOFF, EMILY M (DPT, ATC)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:M
Last Name:PUTHOFF
Suffix:
Gender:F
Credentials:DPT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5933 ETHAN DR
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:41005-6551
Mailing Address - Country:US
Mailing Address - Phone:513-371-6820
Mailing Address - Fax:
Practice Address - Street 1:5933 ETHAN DR
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:KY
Practice Address - Zip Code:41005-6551
Practice Address - Country:US
Practice Address - Phone:513-371-6820
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-14
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT016933225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist