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NPI Code Detail

MEDICARE: MRS. TERESA MACIEJEWSKI PT

MEDICARE: MRS. TERESA MACIEJEWSKI PT
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 Therapist05004289AIN

General Provider Information

NPI Number : 1922104454
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. TERESA MACIEJEWSKI PT
Provider Business Mailing Address
First Line : 1910 SAINT JOE CENTER RD STE 33
Second Line :
City : FORT WAYNE
State : IN
Zip : 46825-5000
Country : US
Telephone Number : 260-483-9933
Fax Number : 260-483-9931
Provider Business Practice Location Address
First Line : 1910 SAINT JOE CENTER RD STE 33
Second Line :
City : FORT WAYNE
State : IN
Zip : 46825-5000
Country : US
Telephone Number : 260-483-9933
Fax Number : 260-483-9931
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/15/2006
Last Update Date : 11/01/2019

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Directions to “ MRS. TERESA MACIEJEWSKI PT” Practice Location

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