MEDICARE: JOHN DENIS SACKREITER PHYSICAL THERAPIST

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT 11408	FL

General Provider Information

NPI Number	:	1053375147
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN DENIS SACKREITER PHYSICAL THERAPIST

Provider Business Mailing Address
First Line	:	9114 SEAFAIR LN
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32317-8189
Country	:	US
Telephone Number	:	850-309-1375
Fax Number	:

Provider Business Practice Location Address
First Line	:	AMERICAN HOMEPATIENT 1307 NORTH MONROE STREET
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32303-5526
Country	:	US
Telephone Number	:	850-681-0080
Fax Number	:	850-681-1022

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/14/2006
Last Update Date	:	07/08/2007

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