Provider Demographics
NPI:1851798300
Name:WHITT, RHONDA (PTA)
Entity Type:Individual
Prefix:
First Name:RHONDA
Middle Name:
Last Name:WHITT
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 S 9TH ST STE 4
Mailing Address - Street 2:
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46060-2631
Mailing Address - Country:US
Mailing Address - Phone:317-204-3736
Mailing Address - Fax:
Practice Address - Street 1:60 PHILLIPS BRANCH RD
Practice Address - Street 2:
Practice Address - City:PHELPS
Practice Address - State:KY
Practice Address - Zip Code:41553-9061
Practice Address - Country:US
Practice Address - Phone:606-456-8725
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-28
Last Update Date:2014-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2306001200225200000X
KYA03272225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant