MEDICARE: JAY C CHEROK DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208100000X	Physical Medicine & Rehabilitation Physician	PHYP2586	AK

General Provider Information

NPI Number	:	1073809190
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAY C CHEROK DPT

Provider Business Mailing Address
First Line	:	81 ARLENE DR
Second Line	:
City	:	NORTH VERSAILLES
State	:	PA
Zip	:	15137-2430
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	601 E PIONEER AVE STE 218
Second Line	:
City	:	HOMER
State	:	AK
Zip	:	99603-7694
Country	:	US
Telephone Number	:	907-235-7473
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/27/2011
Last Update Date	:	08/02/2018

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Directions to “ JAY C CHEROK DPT” Practice Location

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