Provider Demographics
NPI:1437211257
Name:RUNKEL, ROBERT PAUL (DPT)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:PAUL
Last Name:RUNKEL
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2716 SUNSET BLVD
Mailing Address - Street 2:
Mailing Address - City:STEUBENVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43952-1155
Mailing Address - Country:US
Mailing Address - Phone:740-264-0772
Mailing Address - Fax:740-264-0771
Practice Address - Street 1:2716 SUNSET BLVD
Practice Address - Street 2:
Practice Address - City:STEUBENVILLE
Practice Address - State:OH
Practice Address - Zip Code:43952-1155
Practice Address - Country:US
Practice Address - Phone:740-264-0772
Practice Address - Fax:740-264-0771
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-15
Last Update Date:2010-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT 073002251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2213643Medicaid