Provider Demographics
NPI:1487107256
Name:DENNING, NATHAN RANDALL (DPT, SCS, CSCS)
Entity type:Individual
Prefix:
First Name:NATHAN
Middle Name:RANDALL
Last Name:DENNING
Suffix:
Gender:M
Credentials:DPT, SCS, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12808 E MONTE CASINO RD
Mailing Address - Street 2:
Mailing Address - City:FERDINAND
Mailing Address - State:IN
Mailing Address - Zip Code:47532-7636
Mailing Address - Country:US
Mailing Address - Phone:126-869-5508
Mailing Address - Fax:
Practice Address - Street 1:12808 E MONTE CASINO RD
Practice Address - Street 2:
Practice Address - City:FERDINAND
Practice Address - State:IN
Practice Address - Zip Code:47532-7636
Practice Address - Country:US
Practice Address - Phone:126-869-5508
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-28
Last Update Date:2022-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05012134A225100000X, 2251S0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist