Healthcare Provider Details

I. General information

NPI: 1508115437
Provider Name (Legal Business Name): JONATHAN R FROHNING DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2012
Last Update Date: 03/09/2020
Certification Date: 03/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1302 AVENUE OF MID AMERICA STE 3
EFFINGHAM IL
62401-4647
US

IV. Provider business mailing address

PO BOX 5629
EVANSVILLE IN
47716-5629
US

V. Phone/Fax

Practice location:
  • Phone: 812-477-1558
  • Fax: 812-474-2296
Mailing address:
  • Phone: 812-759-7451
  • Fax: 812-401-3259

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number05010912A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: