| Doctor Name: | MARY JANE M CIACICO |
| NPI Number: | 1508983271 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PT, OCS |
| License Number: | 5501006380 |
| Business Practice Address: | 14061 E 13 Mile Rd Suite 1 Warren, MI - 480885866 |
| Business Phone Number: | 5862947077 |
| Business Fax Number: | 5862947144 |
| Mailing Address: | 720 Cool Springs Blvd, Suite 300 FRANKLIN |
| State: | TN |
| Postal Code: | 370672626 |
| Phone Number: | 6157784066 |
| Fax Number: | 6157789114 |
| NPI Enumeration Date: | 03/26/2007 |
| NPI Last Update Date: | 05/01/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 5501006380 |
| 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 |