Provider Demographics
NPI:1467407882
Name:VOLTNER, RON (PTA)
Entity Type:Individual
Prefix:
First Name:RON
Middle Name:
Last Name:VOLTNER
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8560 S STONE CREEK DR
Mailing Address - Street 2:
Mailing Address - City:OAK CREEK
Mailing Address - State:WI
Mailing Address - Zip Code:53154-8515
Mailing Address - Country:US
Mailing Address - Phone:414-769-4939
Mailing Address - Fax:414-769-4935
Practice Address - Street 1:3056 S KK AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53207-2521
Practice Address - Country:US
Practice Address - Phone:414-769-4949
Practice Address - Fax:414-769-4935
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI271-019225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant