Basic Information
Provider Information
NPI: 1346743895
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GILES
FirstName: CODY
MiddleName: STEVEN
NamePrefix:  
NameSuffix:  
Credential: DPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 463 OHIO PIKE STE 203
Address2:  
City: CINCINNATI
State: OH
PostalCode: 452553745
CountryCode: US
TelephoneNumber: 5132474340
FaxNumber: 5132474360
Practice Location
Address1: 1077 STATE ROUTE 28 STE 105
Address2:  
City: MILFORD
State: OH
PostalCode: 451505099
CountryCode: US
TelephoneNumber: 5136532888
FaxNumber: 5139916600
Other Information
ProviderEnumerationDate: 03/12/2018
LastUpdateDate: 06/08/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/08/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000XPT017335OHY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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