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NPI Code Detail

MEDICARE: JAMMIE ANICK

MEDICARE: JAMMIE ANICK
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
1225200000XPhysical Therapy AssistantA797MN

General Provider Information

NPI Number : 1083076335
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMMIE ANICK
Provider Business Mailing Address
First Line : 3855 KENROY RD
Second Line :
City : HERMANTOWN
State : MN
Zip : 55811-1717
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4002 LONDON RD
Second Line :
City : DULUTH
State : MN
Zip : 55804-2243
Country : US
Telephone Number : 218-625-8295
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/25/2016
Last Update Date : 03/25/2016

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Directions to “ JAMMIE ANICK ” Practice Location

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