MEDICARE: DANIEL J. JANIK 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
1	225100000X	Physical Therapist	3347	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1851384606
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL J. JANIK PT

Provider Business Mailing Address
First Line	:	225000 HUMMINGBIRD RD
Second Line	:
City	:	WAUSAU
State	:	WI
Zip	:	54401-2948
Country	:	US
Telephone Number	:	715-387-5511
Fax Number	:

Provider Business Practice Location Address
First Line	:	1767 PARK AVE
Second Line	:
City	:	PLOVER
State	:	WI
Zip	:	54467-4301
Country	:	US
Telephone Number	:	715-393-0479
Fax Number	:

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

Provider Enumeration Date	:	08/26/2005
Last Update Date	:	11/04/2020

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