Provider Demographics
NPI:1306251897
Name:PURKEY, JON (ATC)
Entity type:Individual
Prefix:
First Name:JON
Middle Name:
Last Name:PURKEY
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 321
Mailing Address - Street 2:
Mailing Address - City:CICERO
Mailing Address - State:IN
Mailing Address - Zip Code:46034-0321
Mailing Address - Country:US
Mailing Address - Phone:317-385-8066
Mailing Address - Fax:
Practice Address - Street 1:230 WASHINGTON AVENUE
Practice Address - Street 2:
Practice Address - City:CICERO
Practice Address - State:IN
Practice Address - Zip Code:46034-0321
Practice Address - Country:US
Practice Address - Phone:317-385-8066
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-24
Last Update Date:2014-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer