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General NPI Number Information
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NPI Number | 1508064353
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Entity Type | Individual
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Provider Name | CHRISTOPHER J MAKUCK PT
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Gender | Male
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Dates
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Enumeration Date | 07/03/2007
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Last Update Date | 11/06/2025
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Provider Practice Location Address
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Address Line | 1222 E. WOODLAND AVE
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City | BARRON
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State | WI
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Zip | 54812-1765
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Country | US
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Telephone | 715-838-5222
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 860912
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City | MINNEAPOLIS
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State | MN
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Zip | 55486-0912
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Country | US
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Telephone | 507-284-2511
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Fax |
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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 | 4564-024
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License Number State | WI
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