Provider Demographics
NPI:1295629103
Name:WRONKOSKI, STEVEN
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:WRONKOSKI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:STEVE
Other - Middle Name:
Other - Last Name:WRONKOSKI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:4324 S SHERWOOD FOREST BLVD STE B170
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-4481
Mailing Address - Country:US
Mailing Address - Phone:225-654-8208
Mailing Address - Fax:
Practice Address - Street 1:10161 FLORIDA BLVD STE 300
Practice Address - Street 2:
Practice Address - City:WALKER
Practice Address - State:LA
Practice Address - Zip Code:70785-7944
Practice Address - Country:US
Practice Address - Phone:225-271-8056
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-05
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA12062225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist