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General NPI Number Information
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NPI Number | 1558788190
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Entity Type | Individual
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Provider Name | JEANNE MARIE MARKUSIC P.T.
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Gender | Female
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Dates
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Enumeration Date | 03/20/2014
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Last Update Date | 08/07/2018
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Provider Practice Location Address
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Address Line | 7687 ELLINGTON PL
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City | MENTOR
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State | OH
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Zip | 44060
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Country | US
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Telephone | 216-403-5778
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Fax |
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Provider Business Mailing Address
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Address Line | 7687 ELLINGTON PL
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City | MENTOR
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State | OH
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Zip | 44060-5344
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Country | US
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Telephone | 216-403-5778
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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 | 7336
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 7336
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License Number State | OH
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