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General NPI Number Information
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NPI Number | 1467439737
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Entity Type | Individual
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Provider Name | JOHN D ACKISS PT,DPT, MS,OCS
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Gender | Male
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Dates
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Enumeration Date | 12/28/2005
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Last Update Date | 04/27/2016
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Provider Practice Location Address
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Address Line | 4020 RAINTREE RD SUITE D
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City | CHESAPEAKE
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State | VA
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Zip | 23321-3749
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Country | US
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Telephone | 757-484-4241
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Fax | 757-484-4487
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Provider Business Mailing Address
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Address Line | 771 PILOT HOUSE DR SUITE A
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City | NEWPORT NEWS
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State | VA
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Zip | 23606-1990
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Country | US
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Telephone | 757-873-2302
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Fax | 757-873-2306
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 2305004384
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License Number State | VA
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