Doctor Name: | JARROD MACAK |
NPI Number: | 1548633654 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PT |
License Number: | 05011961A |
Business Practice Address: | 9200 Calumet Ave Suite N-502 Munster, IN - 463212885 |
Business Phone Number: | 2198534633 |
Business Fax Number: | |
Mailing Address: | 8259 Wicker Ave, SAINT JOHN |
State: | IN |
Postal Code: | 463738878 |
Phone Number: | 2193656560 |
Fax Number: | 2193656561 |
NPI Enumeration Date: | 11/11/2015 |
NPI Last Update Date: | 11/11/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 05011961A |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
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 |