Provider Demographics
NPI:1407347222
Name:KNOSE, ELISABETH J
Entity Type:Individual
Prefix:
First Name:ELISABETH
Middle Name:J
Last Name:KNOSE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ELISABETH
Other - Middle Name:J
Other - Last Name:MAYERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:7567 CENTRAL PARKE BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-6855
Mailing Address - Country:US
Mailing Address - Phone:513-701-6100
Mailing Address - Fax:
Practice Address - Street 1:350 THOMAS MORE PKWY STE 130
Practice Address - Street 2:
Practice Address - City:CRESTVIEW HILLS
Practice Address - State:KY
Practice Address - Zip Code:41017-5119
Practice Address - Country:US
Practice Address - Phone:859-578-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-29
Last Update Date:2018-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT-014079225100000X
KYPT-006479225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist