Provider Demographics
NPI:1508848656
Name:ANKROM, WILLIAM K (ATC)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:K
Last Name:ANKROM
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:138 CARMICHAELS ST
Mailing Address - Street 2:
Mailing Address - City:RICES LANDING
Mailing Address - State:PA
Mailing Address - Zip Code:15357-2103
Mailing Address - Country:US
Mailing Address - Phone:724-592-5240
Mailing Address - Fax:
Practice Address - Street 1:138 CARMICHAELS ST
Practice Address - Street 2:
Practice Address - City:RICES LANDING
Practice Address - State:PA
Practice Address - Zip Code:15357-2103
Practice Address - Country:US
Practice Address - Phone:724-592-5240
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART001540A2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer