Provider Demographics
NPI:1881230506
Name:RONCEK, ROBERT (DPT)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:RONCEK
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 1:693 STATE ROUTE 903
Mailing Address - Street 2:
Mailing Address - City:JIM THORPE
Mailing Address - State:PA
Mailing Address - Zip Code:18229-3537
Mailing Address - Country:US
Mailing Address - Phone:570-325-4711
Mailing Address - Fax:
Practice Address - Street 1:693 STATE ROUTE 903
Practice Address - Street 2:
Practice Address - City:JIM THORPE
Practice Address - State:PA
Practice Address - Zip Code:18229-3537
Practice Address - Country:US
Practice Address - Phone:570-325-4711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-19
Last Update Date:2019-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist