Miotke, Richard Joseph

Miotke, Richard Joseph is an individual health care provider with primary practice located at 2601 Ferry St , Lafayette IN 47904-3061. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant, which is considered as his primary health care specialty. Miotke, Richard Joseph can be contacted via phone (765) 448-8000.

Contact Information

Primary practice address
2601 Ferry St Lafayette IN 47904-3061
Phone: (765) 448-8000
Fax: (765) 448-8335
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant 225200000X 06002632A Indiana

Profile Details

NPI number 1851350631
LBN Legal business name Miotke, Richard Joseph
Credentials Physical Therapist Assistant (PTA)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 21st, 2006
Last updated May 10th, 2010 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1851350631 NPPES
Indiana Other 000000188968 ANTHEM PROVIDER NUMBER
Indiana MEDICAID 100099590 ANTHEM PROVIDER NUMBER

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