Provider Demographics
NPI:1295182376
Name:BONECUTTER, JARED (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:JARED
Middle Name:
Last Name:BONECUTTER
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 633448
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-3448
Mailing Address - Country:US
Mailing Address - Phone:513-569-6117
Mailing Address - Fax:513-853-4740
Practice Address - Street 1:421 S CAMPUS AVE
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:OH
Practice Address - Zip Code:45056-2487
Practice Address - Country:US
Practice Address - Phone:513-529-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-19
Last Update Date:2017-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT016306225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist