Provider Demographics
NPI:1952080467
Name:HARNESS, MAGGIE (DPT)
Entity Type:Individual
Prefix:
First Name:MAGGIE
Middle Name:
Last Name:HARNESS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:MAGGIE
Other - Middle Name:
Other - Last Name:WALROTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:6480 HARRISON AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45247-7961
Mailing Address - Country:US
Mailing Address - Phone:513-354-7662
Mailing Address - Fax:513-354-7651
Practice Address - Street 1:9100 CENTRE POINTE DR STE 160
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-4856
Practice Address - Country:US
Practice Address - Phone:513-682-0158
Practice Address - Fax:513-860-0814
Is Sole Proprietor?:No
Enumeration Date:2023-07-12
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT020504225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist