Provider Demographics
NPI:1629593207
Name:OPEKA, MAKENNA ELLEN (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:MAKENNA
Middle Name:ELLEN
Last Name:OPEKA
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:MAKENNA
Other - Middle Name:
Other - Last Name:RODENBUCHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11330 CLEVELAND AVE NW
Mailing Address - Street 2:
Mailing Address - City:UNIONTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44685-8078
Mailing Address - Country:US
Mailing Address - Phone:330-595-9059
Mailing Address - Fax:
Practice Address - Street 1:11330 CLEVELAND AVE NW
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:OH
Practice Address - Zip Code:44685-8078
Practice Address - Country:US
Practice Address - Phone:330-595-9059
Practice Address - Fax:330-595-1525
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-04
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT017132225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist