Healthcare Provider Details

I. General information

NPI: 1801790712
Provider Name (Legal Business Name): NATHAN HARTMAN PTA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

935 E 4TH ST
JUNCTION CITY KS
66441-2867
US

IV. Provider business mailing address

24014 W RENWICK RD STE 206
PLAINFIELD IL
60544-8711
US

V. Phone/Fax

Practice location:
  • Phone: 800-974-4378
  • Fax: 630-515-1536
Mailing address:
  • Phone: 800-974-4378
  • Fax: 630-515-1536

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number14-04458
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: