Basic Information
| Provider Information | |||||||||
| NPI: | 1851798300 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WHITT | ||||||||
| FirstName: | RHONDA | ||||||||
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| Credential: | P.T.A. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10 S 9TH ST STE 4 | ||||||||
| Address2: | |||||||||
| City: | NOBLESVILLE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 460602631 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3172043736 | ||||||||
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| Practice Location | |||||||||
| Address1: | 60 PHILLIPS BRANCH RD | ||||||||
| Address2: | |||||||||
| City: | PHELPS | ||||||||
| State: | KY | ||||||||
| PostalCode: | 415539061 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6064568725 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/28/2014 | ||||||||
| LastUpdateDate: | 11/28/2014 | ||||||||
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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 | 225200000X | 2306001200 | VA | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant | 225200000X | A03272 | KY | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant |
No ID Information.