Provider Demographics
NPI:1073669925
Name:DAY, BETHANY (PT)
Entity Type:Individual
Prefix:
First Name:BETHANY
Middle Name:
Last Name:DAY
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 1:4710 TIMBER TRAIL DR
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:OH
Mailing Address - Zip Code:45044-5349
Mailing Address - Country:US
Mailing Address - Phone:513-423-9496
Mailing Address - Fax:513-727-3806
Practice Address - Street 1:4710 TIMBER TRAIL DR
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:OH
Practice Address - Zip Code:45044-5349
Practice Address - Country:US
Practice Address - Phone:513-423-9496
Practice Address - Fax:513-727-3806
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2007-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT011668225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH286746380005OtherMMOH
OH382617193-30OtherBWC
OH108341Medicaid
OH382617193-30OtherBWC