Provider Demographics
NPI:1184116527
Name:HWANG, PETER (DPT)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:
Last Name:HWANG
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 1:6220 WINDING CREEK BLVD
Mailing Address - Street 2:
Mailing Address - City:LIBERTY TWP
Mailing Address - State:OH
Mailing Address - Zip Code:45011-1153
Mailing Address - Country:US
Mailing Address - Phone:513-907-5500
Mailing Address - Fax:
Practice Address - Street 1:6220 WINDING CREEK BLVD
Practice Address - Street 2:
Practice Address - City:LIBERTY TWP
Practice Address - State:OH
Practice Address - Zip Code:45011-1153
Practice Address - Country:US
Practice Address - Phone:513-907-5500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-01
Last Update Date:2019-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT017195225100000X
GAPT013186225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist