Provider Demographics
NPI:1134484793
Name:KONERMAN, ALISON M (PT, DPT)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:M
Last Name:KONERMAN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:ALISON
Other - Middle Name:M
Other - Last Name:TROJAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4685 FOREST AVE
Mailing Address - Street 2:STE C
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45212-3359
Mailing Address - Country:US
Mailing Address - Phone:513-701-6104
Mailing Address - Fax:
Practice Address - Street 1:5207 MADISON RD
Practice Address - Street 2:300
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45227-1481
Practice Address - Country:US
Practice Address - Phone:513-631-1988
Practice Address - Fax:513-631-3456
Is Sole Proprietor?:No
Enumeration Date:2012-07-10
Last Update Date:2017-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT-013766225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH366632Medicare PIN
OH0214940Medicaid