Doctor Name: | JESSICA LEE SHUDAK |
NPI Number: | 1609996842 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PT |
License Number: | 015041 |
Business Practice Address: | 38 N Main St Pittston, PA - 186401916 |
Business Phone Number: | 5706540220 |
Business Fax Number: | |
Mailing Address: | 5800 Bear Creek Boulevard, P.o. Box 348 BEAR CREEK |
State: | PA |
Postal Code: | 18602 |
Phone Number: | 5704723769 |
Fax Number: | |
NPI Enumeration Date: | 03/30/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 015041 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
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 |