Provider Demographics
NPI:1730187626
Name:NELTNER, AMY NICHOLE (PT)
Entity type:Individual
Prefix:MS
First Name:AMY
Middle Name:NICHOLE
Last Name:NELTNER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4600 WESLEY AVE
Mailing Address - Street 2:STE. N
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45212-2298
Mailing Address - Country:US
Mailing Address - Phone:513-841-5520
Mailing Address - Fax:513-841-1580
Practice Address - Street 1:2915 CLIFTON AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45220-2402
Practice Address - Country:US
Practice Address - Phone:513-872-2000
Practice Address - Fax:513-281-8842
Is Sole Proprietor?:No
Enumeration Date:2005-07-13
Last Update Date:2010-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT-10361225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2513524Medicaid
Q20783Medicare UPIN
OH2513524Medicaid