Provider Demographics
NPI:1669927190
Name:VOLPENHEIN, KELLEY (PT)
Entity type:Individual
Prefix:
First Name:KELLEY
Middle Name:
Last Name:VOLPENHEIN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:KELLEY
Other - Middle Name:
Other - Last Name:HOLZINGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5063 ORANGELAWN DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45238-5721
Mailing Address - Country:US
Mailing Address - Phone:513-504-9090
Mailing Address - Fax:
Practice Address - Street 1:5754 BRIDGETOWN RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45248-3100
Practice Address - Country:US
Practice Address - Phone:513-661-6555
Practice Address - Fax:513-661-6556
Is Sole Proprietor?:No
Enumeration Date:2016-08-25
Last Update Date:2016-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT016383225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHPT016383OtherPT LICENSE