Healthcare Provider Details

I. General information

NPI: 1346446358
Provider Name (Legal Business Name): JACOB J BILLAK D.P.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2007
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 ERIE ST STE B
GROVE CITY PA
16127-1659
US

IV. Provider business mailing address

201 ERIE ST STE B
GROVE CITY PA
16127-1659
US

V. Phone/Fax

Practice location:
  • Phone: 724-264-4640
  • Fax: 724-264-4641
Mailing address:
  • Phone: 724-264-4640
  • Fax: 724-264-4641

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT018752
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: