Individual
ROBERT TANK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, ATC, MA
Contact information
Practice address
4421 N 1ST AVE, EVANSVILLE, IN 47710-3621
(812) 759-3001
(812) 401-9013
Mailing address
7300 E INDIANA ST, STE 102, EVANSVILLE, IN 47715-2794
(812) 476-0409
(812) 476-1016
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
005221
KY
225100000X
Physical Therapist
Primary
05001580A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000272141
BLUE CROSS BLUE SHIELD
IN
05
—
200829440
—
IN
01
—
P00019865
MEDICARE RAILROAD
IN
Enumeration date
12/06/2005
Last updated
02/08/2011
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