Doctor Name: | MR. STEPHEN DOUGLAS MACKO |
NPI Number: | 1205074564 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MPT |
License Number: | L1392730 |
Business Practice Address: | 7105 Allen Rd Ste B Allen Park, MI - 481012009 |
Business Phone Number: | 3133882853 |
Business Fax Number: | |
Mailing Address: | 1038 Marshfield St, FERNDALE |
State: | MI |
Postal Code: | 482202346 |
Phone Number: | 3133991920 |
Fax Number: | |
NPI Enumeration Date: | 01/25/2009 |
NPI Last Update Date: | 01/25/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | L1392730 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |