Provider Demographics
NPI:1992785810
Name:PHILLIPS, CARA M (MPT)
Entity type:Individual
Prefix:MRS
First Name:CARA
Middle Name:M
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:MS
Other - First Name:CARA
Other - Middle Name:M
Other - Last Name:SALVATI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:6480 HARRISON AVENUE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45247
Mailing Address - Country:US
Mailing Address - Phone:513-354-3700
Mailing Address - Fax:513-354-7651
Practice Address - Street 1:500 E- BUSINESS WAY
Practice Address - Street 2:SUITE C
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45241
Practice Address - Country:US
Practice Address - Phone:513-389-3666
Practice Address - Fax:513-389-3665
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2012-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT097252251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH530926OtherWELLCARE
OH2987095Medicaid
OH000000610042OtherANTHEM
OHPH4150425Medicare PIN