Provider Demographics
NPI:1265409866
Name:MADARANG, RICHARD T (PT)
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:T
Last Name:MADARANG
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 1:512 LIBERTY HL
Mailing Address - Street 2:4A
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45202-6892
Mailing Address - Country:US
Mailing Address - Phone:513-200-7774
Mailing Address - Fax:
Practice Address - Street 1:8250 KENWOOD CROSSING WAY
Practice Address - Street 2:SUITE 200
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-3668
Practice Address - Country:US
Practice Address - Phone:513-221-5500
Practice Address - Fax:513-221-1856
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT11130225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist