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NPI Code Detail

MEDICARE: MISS DANIELLE EKOVICH PTA

MEDICARE: MISS DANIELLE EKOVICH PTA
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 Assistant06003228AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1200812210OTHERINFIRST STEPS PROVIDER

General Provider Information

NPI Number : 1700963543
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS DANIELLE EKOVICH PTA
Provider Business Mailing Address
First Line : 1120 S CALUMET RD STE 3
Second Line :
City : CHESTERTON
State : IN
Zip : 46304-3286
Country : US
Telephone Number : 219-983-9675
Fax Number :
Provider Business Practice Location Address
First Line : 1120 S CALUMET RD STE 3
Second Line :
City : CHESTERTON
State : IN
Zip : 46304-3286
Country : US
Telephone Number : 219-983-9675
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2006
Last Update Date : 04/08/2014

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