Provider Demographics
NPI:1093320129
Name:KOUNTZ, JOSEPH MITCHELL (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:MITCHELL
Last Name:KOUNTZ
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1133 MERRILLVILLE RD
Mailing Address - Street 2:
Mailing Address - City:CROWN POINT
Mailing Address - State:IN
Mailing Address - Zip Code:46307-2710
Mailing Address - Country:US
Mailing Address - Phone:219-661-8008
Mailing Address - Fax:219-661-8998
Practice Address - Street 1:1133 MERRILLVILLE RD
Practice Address - Street 2:
Practice Address - City:CROWN POINT
Practice Address - State:IN
Practice Address - Zip Code:46307-2710
Practice Address - Country:US
Practice Address - Phone:219-661-8008
Practice Address - Fax:219-661-8998
Is Sole Proprietor?:No
Enumeration Date:2020-09-15
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05013855A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist