Basic Information
| Provider Information | |||||||||
| NPI: | 1104883065 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SEMAN | ||||||||
| FirstName: | DEBRA | ||||||||
| MiddleName: | L. | ||||||||
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| Credential: | PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4700 SMITH RD | ||||||||
| Address2: | SUITE A | ||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452122787 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5136196885 | ||||||||
| FaxNumber: | 5135336001 | ||||||||
| Practice Location | |||||||||
| Address1: | 540 LINCOLN PARK BLVD | ||||||||
| Address2: | SUITE 350 | ||||||||
| City: | KETTERING | ||||||||
| State: | OH | ||||||||
| PostalCode: | 454296401 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9373128100 | ||||||||
| FaxNumber: | 9373128101 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/26/2006 | ||||||||
| LastUpdateDate: | 03/05/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208100000X | PT-07567 | OH | Y | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation |
ID Information
| ID | Type | State | Issuer | Description | 2511376 | 05 | OH | MEDICAID |