MEDICARE: MR. ANDREW THOMAS KRONENBERGER DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2251X0800X	Orthopedic Physical Therapist	017520	OH

General Provider Information

NPI Number	:	1871060616
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ANDREW THOMAS KRONENBERGER DPT

Provider Business Mailing Address
First Line	:	491 MORSE RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43214-1832
Country	:	US
Telephone Number	:	330-635-6008
Fax Number	:

Provider Business Practice Location Address
First Line	:	8849 WHITNEY DR
Second Line	:
City	:	LEWIS CENTER
State	:	OH
Zip	:	43035-7107
Country	:	US
Telephone Number	:	740-549-7041
Fax Number	:	740-549-7045

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/30/2018
Last Update Date	:	08/09/2020

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