| Doctor Name: | DR. JEFFREY ALLAN DAMASCHKE |
| NPI Number: | 1427021807 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DPT, MS, OCS |
| License Number: | |
| Business Practice Address: | 3001 6th St Physical Therapy Department Great Lakes, IL - 600882833 |
| Business Phone Number: | 8476882368 |
| Business Fax Number: | |
| Mailing Address: | 3001 6th St, Physical Therapy Department GREAT LAKES |
| State: | IL |
| Postal Code: | 600882833 |
| Phone Number: | 8476882368 |
| Fax Number: | |
| NPI Enumeration Date: | 02/08/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 171000000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Military Health Care Provider |
| Taxonomy Specialization: | |
| Taxonomy Definition: | Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes. |