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Individual
TESSE LANE MACIEJKO
Active
Individual
TESSE LANE MACIEJKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
196622
AK
225100000X
Physical Therapist
21536
MT
225100000X
Physical Therapist
318
VI
225100000X
Physical Therapist
PT7383
ME
225100000X
Physical Therapist
Primary
PTL.0016628
CO
Other
Enumeration date
09/13/2019
Last updated
04/02/2026
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