Provider Demographics
NPI:1962504852
Name:TANK, RODNEY G (PT)
Entity Type:Individual
Prefix:
First Name:RODNEY
Middle Name:G
Last Name:TANK
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2312 S DIXON RD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:KOKOMO
Mailing Address - State:IN
Mailing Address - Zip Code:46902-6401
Mailing Address - Country:US
Mailing Address - Phone:765-455-2122
Mailing Address - Fax:765-455-3122
Practice Address - Street 1:641 WESTFIELD RD
Practice Address - Street 2:
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46060-1323
Practice Address - Country:US
Practice Address - Phone:317-776-2122
Practice Address - Fax:317-776-2622
Is Sole Proprietor?:No
Enumeration Date:2006-09-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN05002736A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist