Provider Demographics
NPI:1285075192
Name:MACHAN, TIMOTHY ERNEST (DPT)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:ERNEST
Last Name:MACHAN
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 1:2751 OVARSITY WAY
Mailing Address - Street 2:ROOM 265
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45221-0001
Mailing Address - Country:US
Mailing Address - Phone:513-556-3178
Mailing Address - Fax:
Practice Address - Street 1:2751 OVARSITY WAY
Practice Address - Street 2:ROOM 265
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45221-0001
Practice Address - Country:US
Practice Address - Phone:513-556-3178
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-09
Last Update Date:2013-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH014362225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist