Provider Demographics
NPI:1346326477
Name:ELSER, TIM M (PT)
Entity Type:Individual
Prefix:MR
First Name:TIM
Middle Name:M
Last Name:ELSER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6480 HARRISON AVENUE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45247-4617
Mailing Address - Country:US
Mailing Address - Phone:513-354-7777
Mailing Address - Fax:513-354-7778
Practice Address - Street 1:6480 HARRISON AVENUE
Practice Address - Street 2:SUITE 202
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45247
Practice Address - Country:US
Practice Address - Phone:513-354-7777
Practice Address - Fax:513-354-7778
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2020-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT-003633225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000494925OtherANTHEM
OH2733108Medicaid
OH415735OtherWELLCARE
OHEL4194571Medicare PIN