Provider Demographics
NPI:1215901673
Name:SHUMRICK, PATRICK L (DPT)
Entity type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:L
Last Name:SHUMRICK
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 30155
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45230-0155
Mailing Address - Country:US
Mailing Address - Phone:513-891-0934
Mailing Address - Fax:513-891-1323
Practice Address - Street 1:4815 COOPER RD STE 102
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45242-7076
Practice Address - Country:US
Practice Address - Phone:513-891-0934
Practice Address - Fax:513-891-1323
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2016-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT04938225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2376549Medicaid
OH2376549Medicaid