Provider Demographics
NPI:1689301269
Name:GILLESPIE, STEVEN KENT (DPT)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:KENT
Last Name:GILLESPIE
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:791 NEEB RD APT 8
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45233-4638
Mailing Address - Country:US
Mailing Address - Phone:513-673-5141
Mailing Address - Fax:
Practice Address - Street 1:3187 WESTERN ROW RD STE 102
Practice Address - Street 2:
Practice Address - City:MAINEVILLE
Practice Address - State:OH
Practice Address - Zip Code:45039-8012
Practice Address - Country:US
Practice Address - Phone:513-459-8599
Practice Address - Fax:513-459-8746
Is Sole Proprietor?:No
Enumeration Date:2022-08-04
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT020014225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist