Provider Demographics
NPI:1275757817
Name:PERSONAL SYMMETRICS
Entity Type:Organization
Organization Name:PERSONAL SYMMETRICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:V
Authorized Official - Last Name:ROSENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:CERTIFIED FITTER
Authorized Official - Phone:513-221-7200
Mailing Address - Street 1:3366 CENTRAL PKWY
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45225-2307
Mailing Address - Country:US
Mailing Address - Phone:513-221-7200
Mailing Address - Fax:
Practice Address - Street 1:3366 CENTRAL PKWY
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45225-2307
Practice Address - Country:US
Practice Address - Phone:513-221-7200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0598705Medicaid
OH0598705Medicaid