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General NPI Number Information
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NPI Number | 1710863691
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Entity Type | Organization
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Legal Business Name | MCDONALD PHYSICAL THERAPY AND SPORTS REHABILITATION CENTER
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Dates
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Enumeration Date | 08/14/2025
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Last Update Date | 08/14/2025
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Provider Practice Location Address
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Address Line | 1005 N HICKORY RD
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City | SOUTH BEND
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State | IN
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Zip | 46615
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Country | US
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Telephone | 574-233-5754
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Fax | 574-233-7406
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Provider Business Mailing Address
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Address Line | 1005 N HICKORY RD
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City | SOUTH BEND
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State | IN
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Zip | 46615
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Country | US
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Telephone | 574-233-5754
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Fax | 574-233-7406
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Authorized Official
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Title or Position | PHYSICAL THERAPIST/CLINICAL MANAGER
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Name | MR. FRANCIS JOSEPH MCDONALD
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Credential | PT, DPT
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Telephone | 574-229-4003
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number |
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License Number State |
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