Provider Demographics
NPI:1225121718
Name:KANTNER, ROBERT M (PT)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:M
Last Name:KANTNER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3039 PLUMBROOK
Mailing Address - Street 2:
Mailing Address - City:MAUMEE
Mailing Address - State:OH
Mailing Address - Zip Code:43537
Mailing Address - Country:US
Mailing Address - Phone:419-882-5954
Mailing Address - Fax:419-474-2505
Practice Address - Street 1:3039 PLUMBROOK
Practice Address - Street 2:
Practice Address - City:MAUMEE
Practice Address - State:OH
Practice Address - Zip Code:43537
Practice Address - Country:US
Practice Address - Phone:419-882-5954
Practice Address - Fax:419-474-2505
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2422579Medicaid
MIN91050002Medicare ID - Type Unspecified
OH2422579Medicaid
OHKA4031151Medicare ID - Type Unspecified