Steven E Konkle
Individual provider Active NPI Physical Therapist · Vevay, IN
NPI 1104214535 · NPPES record last updated Apr 23, 2015
Key facts
- NPI
- 1104214535
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- Practice address
- 1190 W Main St
Vevay, IN 47043-3639 - Phone
- (812) 427-2693
- Fax
- (812) 427-2936
- NPI assigned
- Jan 8, 2015
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Yes |
Addresses
Primary practice location
1190 W Main St
Vevay, IN 47043-3639
Mailing address
PO Box 189
Madison, IN 47250-0189
Phone (812) 427-2693
Other providers in Vevay, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 23, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.