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NPI Code Detail

MEDICARE: MICHAEL J MESECK MPT

MEDICARE: MICHAEL J MESECK MPT
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
1225100000XPhysical Therapist4844SC

General Provider Information

NPI Number : 1457392268
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL J MESECK MPT
Provider Business Mailing Address
First Line : 790 REMINGTON BLVD
Second Line :
City : BOLINGBROOK
State : IL
Zip : 60440-4909
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8091 RIVERS AVE
Second Line :
City : NORTH CHARLESTON
State : SC
Zip : 29406-9236
Country : US
Telephone Number : 843-824-9251
Fax Number : 843-824-9254
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2006
Last Update Date : 10/29/2024

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Directions to “ MICHAEL J MESECK MPT” Practice Location

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