| Nicole M Latreille, | |
|
7591 Tylers Place Blvd, West Chester, OH 45069-6308 | |
| (513) 755-6600 | |
| (513) 755-3762 |
| Full Name | Nicole M Latreille |
|---|---|
| Gender | Female |
| Speciality | Physical Therapist |
| Location | 7591 Tylers Place Blvd, West Chester, Ohio |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215444997 | NPI | - | NPPES |
| 0406425 | Medicaid | OH | |
| AB7360731 | Other | OH | MEDICARE PIN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | PT017260 (Ohio) | Primary |
| Provider Name | Big Blue Canopy Llc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1548820772 PECOS PAC ID: 4880029123 Enrollment ID: O20200115001259 |
| Mailing Address | Practice Location Address |
|---|---|
| Nicole M Latreille, 7591 Tylers Place Blvd, West Chester, OH 45069-6308 Ph: (513) 755-6600 | Nicole M Latreille, 7591 Tylers Place Blvd, West Chester, OH 45069-6308 Ph: (513) 755-6600 |
Mobility Fit Physical Therapy Llc Physical Therapist Medicare: Medicare Enrolled Practice Location: 7782 Service Center Dr, West Chester, OH 45069 Phone: 303-710-0515 Fax: 888-972-7349 | |
Diane L Crecelius, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 9902 Windisch Rd, West Chester, OH 45069 Phone: 513-755-6600 Fax: 513-755-3762 | |
Jacob Hancock, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 8020 Liberty Way, West Chester, OH 45069 Phone: 513-527-6414 Fax: 513-860-0713 | |
Dr. Andrew Samuel Cook, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 7753 Cox Lane Box 31, West Chester, OH 45069 Phone: 303-710-0515 | |
Mckenna Shives, Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 5531 Chappell Crossing Blvd, West Chester, OH 45069 Phone: 877-407-3422 Fax: 877-407-4329 | |
Alyssa Taylor, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 7591 Tylers Place Blvd, West Chester, OH 45069 Phone: 513-755-6600 Fax: 513-755-3762 | |
Kelly Fornadel, PT, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 8734 Union Centre Blvd, West Chester, OH 45069 Phone: 513-232-2663 |