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NPI Code Detail

MEDICARE: MACIEJ JASKIEWICZ PT

MEDICARE: MACIEJ JASKIEWICZ PT
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
1225100000XPhysical Therapist05003192AIN

General Provider Information

NPI Number : 1164963989
Entity Type Code : Individual
Provider Name (Legal Business Name) : MACIEJ JASKIEWICZ PT
Provider Business Mailing Address
First Line : 3600 W BETHEL AVE
Second Line :
City : MUNCIE
State : IN
Zip : 47304-5407
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 60160 BODNAR BLVD
Second Line :
City : MISHAWAKA
State : IN
Zip : 46544-9338
Country : US
Telephone Number : 574-247-9441
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/13/2017
Last Update Date : 01/16/2025

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Directions to “ MACIEJ JASKIEWICZ PT” Practice Location

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