Provider Demographics
NPI:1407922032
Name:HOWELL, ALAN JAY (PT ATC SCS)
Entity Type:Individual
Prefix:MR
First Name:ALAN
Middle Name:JAY
Last Name:HOWELL
Suffix:
Gender:M
Credentials:PT ATC SCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5400 KENNEDY AVENUE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45213
Mailing Address - Country:US
Mailing Address - Phone:513-618-7878
Mailing Address - Fax:513-618-7888
Practice Address - Street 1:5400 KENNEDY AVENUE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45213
Practice Address - Country:US
Practice Address - Phone:513-618-7878
Practice Address - Fax:513-618-7888
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT2332225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2455767Medicaid
H00872582Medicare ID - Type Unspecified