Basic Information
| Provider Information | |||||||||
| NPI: | 1881043479 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ESPITIA | ||||||||
| FirstName: | ANGELENA | ||||||||
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| Credential: | DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6480 HARRISON AVE STE 201 | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452477961 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5133547650 | ||||||||
| FaxNumber: | 5133547651 | ||||||||
| Practice Location | |||||||||
| Address1: | 5900 BOYMEL DR | ||||||||
| Address2: | |||||||||
| City: | FAIRFIELD | ||||||||
| State: | OH | ||||||||
| PostalCode: | 450145526 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5133543700 | ||||||||
| FaxNumber: | 5133543705 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/06/2016 | ||||||||
| LastUpdateDate: | 07/30/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/30/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.